Effect of Age on Response to Therapy and Mortality in Patients With Thyroid Cancer at High Risk of Recurrence

Shah, Sona; Boucai, Laura

doi:10.1210/jc.2017-02255

Cited by 61 publications

(49 citation statements)

References 34 publications

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“…Younger age was identified to be associated with aggressiveness of PTC, such as vascular invasion and lymph node metastases (26). However, there is mounting evidence that younger PTC patients have a better disease-specific survival although they present high-risk clinical-pathological features (27)(28)(29). For PTMC under active surveillance, younger age was also associated with more probability of disease progression like tumor enlargement by ≥3 mm or novel appearance of nodal metastasis (30).…”

Section: Discussionmentioning

confidence: 99%

Clinical and Ultrasonic Risk Factors for Lateral Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-Analysis

et al. 2020

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Background: Clinical and ultrasonic risk factors for lateral lymph node metastasis (LLNM) in papillary thyroid microcarcinoma (PTMC) are not well-defined. Herein, a systematic review and meta-analysis was conducted to investigate clinicopathologic and ultrasonic risk features for LLNM in PTMC. Methods: A systematic search of electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) for studies published until April 2019 was performed. Case-control studies and randomized controlled trials that studied clinical and ultrasonic risk factors of LLNM in PTMC were included. Results: Fourteen studies (all retrospective studies) involving 43,750 patients met final inclusion criteria. From the pooled analyses, younger age<45 (OR, 1.

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Section: Discussionmentioning

confidence: 99%

Clinical and Ultrasonic Risk Factors for Lateral Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-Analysis

et al. 2020

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“…However, a tendency toward a lower frequency of structural incomplete response was observed at the end of follow-up in patients with intermediate and high RR less than 40 years, without statistical significance. Indeed, other authors demonstrated that age was a key predictor for the response to therapy in patients with high RR (Shah et al 2018). Moreover, high-risk younger patients with a structural incomplete response to therapy had a significantly better disease specific survival (DSS) than older patients (74 vs 12%, respectively, P < 0.001) (Shah et al 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, other authors demonstrated that age was a key predictor for the response to therapy in patients with high RR (Shah et al 2018). Moreover, high-risk younger patients with a structural incomplete response to therapy had a significantly better disease specific survival (DSS) than older patients (74 vs 12%, respectively, P < 0.001) (Shah et al 2018). The RR classification system was also validated in patients with low and intermediate risk or recurrence who did not receive RA.…”

Section: Introductionmentioning

confidence: 99%

Dynamic risk assessment in patients with differentiated thyroid cancer

Pitoia

Jerkovich

2019

Endocrine-Related Cancer

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The stratification of patients with differentiated thyroid cancer based on their initial risk of recurrence, according to specific clinical, histopathological and perioperative data, is an important starting point for tailoring the follow-up during the first 1–2 years after initial therapy (surgery with or without radioiodine ablation). However, risk of recurrence re-stratification based on new clinical data that becomes available after considering the response to treatment (dynamic risk assessment) provides a more accurate prediction of the status at final follow-up and a more individualized approach. In this review, we summarized the available data regarding dynamic risk of recurrence and the suggested management of differentiated thyroid cancer patients according to the response to treatment. The use of this strategy is crucial to avoid overtreatment and intensive follow-up of the vast majority of patients who will have a very good prognosis and, on the other hand, focus therapeutic efforts on those patients who will have a worse prognosis. In the future, molecular biology analysis of the tumors and well-designed prospective studies will probably refine the risk of recurrence prediction.

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“…For papillary carcinoma, the presence of distant metastases in elderly patients as well as carcinomas with tumor size above 3 cm requiring aggressive intervention in younger ones are recognized to be important prognostic factors [9]. According to some other information, only distant metastases into bones belong to negative prognostic factors [26], the patient's age is thought to be an important prediction factor only for drug response prognosis [27].…”

Section: Groupsmentioning

confidence: 99%

Main Prognostic Factors for Well Differentiated Thyroid Cancer: Analis of Combined Patients Treatment Results during 20 Years after Surgery

Bb¹,

Ae²,

My³

et al. 2018

Thyroid Disorders Ther

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Background: In general, the prognosis in patients with well differentiated thyroid carcinoma (WDTC) is excellent. However, there are small cohorts of patients who experience a more aggressive form of disease which is often associated with certain poor prognostic factors. Identifying these patients at an early stage is imperative for guiding treatment decisions. The purpose of the work is to study the cumulative survival of patients with WDTC, depending on a number of clinical and biological characteristics of tumors. Methods: A retrospective cohort study of patients operated on WDTC in the period from 1995 to 2015 (5526 people). Each patient was analyzed according to age, gender, tumor size and characteristics of the TNM (7 editions), clinical stage, volume of surgery, number of points on the MACIS scale, risk group, number of courses of radioiodine treatment, result treatment and the term of postoperative observation. The construction of cumulative survival curves was made according to the Kaplan-Meier approach. To compare the cumulative survival index value in groups, the non-parametric Log-rank test was used. Results: The most unfavorable factors of the prognosis for patients with WDTC are such integrated indicators as the stage of disease IVb and IVc, as well as tumors of the T4b category. It is also unfavorable to recognize the age of patients over 60 years, the presence of distant metastases, the stage of disease IVa, the category of carcinomas T4a and the size of the tumor more than 40 mm. Other prognostic factors (invasion, multifocal tumor growth, metastasis of carcinoma to the lymph nodes, male sex, post-operative relapse), although they are probable predictive factors, but have somewhat less significance in analyzing the prognosis of survival of patients. Conclusion: Understanding the importance of certain prognostic factors of survival is extremely necessary, since they are the only indicators of the effectiveness of the diagnostic, medical and organizational work will reduce the number of patients who require aggressive treatments and, consequently, increase the duration and quality of their postoperative life.

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Effect of Age on Response to Therapy and Mortality in Patients With Thyroid Cancer at High Risk of Recurrence

Abstract: Age was a key predictor of response to therapy and disease-specific survival in ATA high-risk thyroid cancer patients. Its incorporation as a variable in the ATA risk stratification system would improve its power to predict response to therapy as well as mortality.

Cited by 61 publications

References 34 publications

Clinical and Ultrasonic Risk Factors for Lateral Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-Analysis

Clinical and Ultrasonic Risk Factors for Lateral Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-Analysis

Dynamic risk assessment in patients with differentiated thyroid cancer

Main Prognostic Factors for Well Differentiated Thyroid Cancer: Analis of Combined Patients Treatment Results during 20 Years after Surgery

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