Clinical detection of “extremely low‐risk” follicular thyroid carcinoma: A population‐based study of 7304 patients

Abstract

Background: Previous studies have not been consistent in the risk of metastasis in follicular thyroid carcinoma (FTC). Therefore, we conducted a large population study to stratify the risk of distant metastasis in FTC patients using only clinical parameters. Methods:We extracted FTC patients from The Surveillance, Epidemiology, and End Results (SEER) database and divided them into training and validation cohorts. Results:The two cohorts consisted of 4913 and 2391 patients, respectively. We developed a nomogram and risk table based on a logistic regression model using algorithm-selected variables. Receiver Operating Characteristic (ROC) analyses showed high discriminatory power in the training and validation cohorts (Area under the curve [AUC] of 0.85 and 0.84, respectively). Extremely low, low, intermediate, and high-risk groups had 0.3%, 1%, 3.5%, and 16.7% risk of distant metastasis, respectively.Conclusions: Our risk scoring table can separates patients into four risk groups and efficiently detect patients with almost no risk of metastasis.

Prognosis and influencing factors of follicular thyroid cancer

“…Individuals who present with metastatic FTC should therefore be treated aggressively with thyroidectomy, radioiodine ablation, and resection of the metastasis where possible 2 . Some studies found that age, lesion size, histology, vascular invasiveness, extraglandular invasiveness, and metastasis were found to be risk factors for increased tumor‐specific mortality in patients with FTC 21,30,31 . Several independent risk factors for FTC are reported in the literature, including increased nodule size (>40 mm), which were consistent with our findings 3 .…”

“…2 Some studies found that age, lesion size, histology, vascular invasiveness, extraglandular invasiveness, and metastasis were found to be risk factors for increased tumor-specific mortality in patients with FTC. 21,30,31 Several independent risk factors for FTC are reported in the literature, including increased nodule size (>40 mm), which were consistent with our findings. 3 The prognosis of small lesions of WIFTC is worse than that nodule size >40 mm of MIFTC, which shows that WIFTC has a greater aggressiveness.…”

“…Our retrospective analysis revealed age disparities among the three groups of FTC patients. Some studies have suggested that older patients are more susceptible to distant metastasis 21 . The association between HT and thyroid cancer is currently a subject of controversy, with the prevailing belief that HT is linked to an increased risk of developing thyroid cancer 22 .…”

“…Some studies have suggested that older patients are more susceptible to distant metastasis. 21 The association between HT and thyroid cancer is currently a subject of controversy, with the prevailing belief that HT is linked to an increased risk of developing thyroid cancer. 22 In our study, the highest proportion of patients with HT and the least favorable prognosis in the M1 group seem to support this perspective.…”