Does T Stage Affect Prognosis in Patients With Stage Iv B Differentiated Thyroid Cancer

Trivedi, Nitin; Dai, Chenyang; Mao, Rui; Wang, Yuning; Ning, Ying; Gu, Sophie Z.; Huo, Lihong; Siddiqui, Ahmad Daniyal

doi:10.4158/ep-2019-0051

Cited by 16 publications

(13 citation statements)

References 27 publications

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“…The results of our study for all TC cases were consistent with previous studies ( 19 , 23 , 24 ) that reported the adverse impact of tumor size on the prognosis of TCs. In all patients, tumor size >4 cm was the most robust risk factor of TC-specific mortality without considering the impact of the N category.…”

Section: Discussionsupporting

confidence: 92%

“…However, even with the same TNM stage, the prognosis for patients still remains controversial ( 15 – 17 ). Recent studies ( 18 , 19 ) have been conducted to determine the influence of tumor size on the cancer-specific survival of patients in stage IVB. It has been illustrated that the larger tumor size may be associated with a higher risk of cancer-specific mortality in stage IVB TC patients.…”

Section: Introductionmentioning

confidence: 99%

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The Increased Risk of Thyroid Cancer-Specific Mortality With Tumor Size in Stage IVB Patients

Zhang

Cheng

et al. 2020

Front. Oncol.

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Purpose: To investigate the risk-stratifying utility of tumor size and a threshold for further stratification on cancer-specific mortality of thyroid cancer (TC) patients in stage IVB. Methods: One thousand three hundred and forty-five patients (620 males and 725 females) with initial distant metastasis over 55 years between 2004 and 2016 from Surveillance, Epidemiology, and End Results databases were investigated, with a median follow-up time of 23 months [interquartile range (IQR), 5-56 months] and a median age of 70 years (IQR, 63-77 years). TC-specific mortality rates were calculated under different classifications. Cox regressions were used to calculate hazard ratios (HRs) and Kaplan-Meier Analyses were conducted to investigate TC-specific survivals. Results: In the whole cohort, patients with tumors >4 cm had the highest TC-specific mortality (67.9%, 330/486), followed by tumor size >1 cm but ≤4 cm (43.08%, 190/441), and tumor size ≤1 cm (32.69%, 34/104). Kaplan-Meier curves showed the increased tumor size was associated with a statistically significant decrease in TC-specific survival (P < 0.001). Papillary thyroid cancer (PTC) patients with tumors >4 cm had significantly higher hazard ratios (HRs) of 2.84 (1.72-4.70) and 3.11 (1.84-5.26) after adjusting age, gender, race, and radiation treatment, compared with patients with tumors ≤1 cm (P < 0.001). The TC-specific mortalities and survivals were further investigated among more detailed subgroups divided by different tumor size, and a threshold of 3 cm could be observed (P < 0.005) for risk stratification. Conclusions: Mortality risk increased with tumor size in PTC patients in stage IVB. Our findings demonstrated the possibility of further stratification in IVB stage in current TNM staging system. Patients with tumor size over 3 cm had an excessively high risk of PTC-specific mortality, which may justify the necessity of more aggressive treatment for them.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

The Increased Risk of Thyroid Cancer-Specific Mortality With Tumor Size in Stage IVB Patients

Zhang

Cheng

et al. 2020

Front. Oncol.

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“…In patients with DM, multivariate Cox analysis showed that tumor grade, age at diagnosis, T stage, N stage, marital status, and the administration of surgery was a prognostic factor for OS. Many previous studies have found that age at diagnosis, T stage, N stage, and tumor differentiation played important roles in cancer survival outcomes 31–33 . Moreover, CN has been recognized to have survival benefits in mRCC patients.…”

Section: Discussionmentioning

confidence: 99%

“…Many previous studies have found that age at diagnosis, T stage, N stage, and tumor differentiation played important roles in cancer survival outcomes. [31][32][33] Moreover, CN has been recognized to have survival benefits in mRCC patients. As for CSS, higher median household income was associated with better prognosis.…”

Section: Discussionmentioning

confidence: 99%

Patterns of distant metastases in patients with clear cell renal cell carcinoma––A population‐based analysis

Xue

Chen

et al. 2020

Cancer Medicine

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We developed this study to describe the patterns of distant metastasis (DM) and explore the predictive and prognostic factors of DM in clear cell renal cell carcinoma (ccRCC) patients. We collected the eligible patients from the Surveillance, Epidemiology, and End Result (SEER) database from 2010 to 2015. Then, comparisons of baseline characteristics between patients in different metastatic patterns were made. In addition, proportional mortality ratios (PMRs) and proportion trends of different patterns were calculated. Afterward, survival outcomes were explored by Kaplan–Meier (KM) analyses. Finally, predictive and prognostic factors of DM were investigated. A total of 33,449 ccRCC patients were eventually identified, including 2931 patients with DM and 30,518 patients without DM. 8.76% of patients suffered DM at their initial diagnosis, 35.01% of them had multiple metastases. Generally, lung (6.19%) was the most common metastatic site in patients with DM, and brain (1.20%) was the least frequent metastatic organ. The proportion trends of different metastatic patterns tended to be stable between 2010 and 2015. Moreover, higher tumor grade, T stage, and N stage were identified as risk factors of DM. Finally, age at diagnosis, grade, T stage, N stage, the administration of surgery, the number of metastatic sties, marital status, and household income were found to be significantly associated with prognosis. Lung was the most common metastatic site in ccRCC patients. Different survival outcomes and prognostic factors were identified for different metastatic patterns. Hence, our study would have great value for clinical practice in the future.

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“…Concerning the TNM classi cation, higher PLR, but not NLR, was signi cantly associated with advanced T stages, which may potentially re ect a poorer overall survival and cancer-speci c survival [33]. NLR, PLR and SII were associated with advanced AJCC staging, but neither of them were found as independent predictive markers for lymph-node or distant metastasis.…”

Section: Discussionmentioning

confidence: 89%

Preoperative serum inflammation-based scores in medullary thyroid cancer

Figueiredo¹,

Esteves²,

Moura³

et al. 2021

Preprint

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Introduction: Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) are prognostic factors in several tumours, however little is known in medullary thyroid cancer (MTC). Objective: To evaluate the association between preoperative NLR, PLR and SII with MTC clinicopathological and molecular features, and their predictive value for lymph-node and distant metastasis. Methods: We retrospectively analysed 75 patients with MTC who underwent surgery at our institution. Results: In our cohort, 56% were females, the median age at diagnosis was 57 years (44–69), the median tumour diameter was 25mm (15–50); 21.3% were multifocal and 34.7% had extrathyroidal extension. Fibrosis was present in 30 of the 37 analysed samples; RET somatic status was assessed in 35 cases and 21 harboured a mutation. Lymph-node and distant metastasis were observed in 36 (48.0%) and 8 (10.7%), respectively. Higher NLR was associated with preoperative calcitonin, angioinvasion, extrathyroidal extension, moderate/severe fibrosis; higher PLR was associated to extrathyroidal extension and advanced T stages; lower SII and NLR were associated with biochemical cure after surgery. Increased PLR, NLR and SII were associated with advanced MTC stages. In the univariate analysis, only NLR was associated with lymph-node metastasis (odds ratio (OR) = 2.69, 95% confidence interval (CI): 1.50–5.84; p = 0.004); however, in the multivariate model, NLR was no longer a predictive factor for lymph-node metastasis. Conclusion: None of these serum inflammatory markers predicted the occurrence of distant metastasis. In conclusion, NLR, PLR and SII may indicate aggressive MTC disease, but do not predict lymph-node or distant metastasis.

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Does T Stage Affect Prognosis in Patients With Stage Iv B Differentiated Thyroid Cancer

Cited by 16 publications

References 27 publications

The Increased Risk of Thyroid Cancer-Specific Mortality With Tumor Size in Stage IVB Patients

The Increased Risk of Thyroid Cancer-Specific Mortality With Tumor Size in Stage IVB Patients

Patterns of distant metastases in patients with clear cell renal cell carcinoma––A population‐based analysis

Preoperative serum inflammation-based scores in medullary thyroid cancer

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