Sex Differences in Differentiated Thyroid Cancer

Shobab, Leila; Burman, Kenneth D.; Wartofsky, Léonard

doi:10.1089/thy.2021.0361

Cited by 56 publications

(38 citation statements)

References 156 publications

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“…Age is considered a selection variable for AS in patients with low-risk PTMC, 26 and younger age was suggested as a predictive marker for early progression, 12 which was also consistent with our study showing 2.76 times higher progression in patients with age <30 years. Male sex was also reported to be associated with adverse outcomes of papillary thyroid cancer, 27 and this was confirmed in our results with a 2.45 times higher progression rate than females.…”

Section: Discussionsupporting

confidence: 89%

Progression of Low-Risk Papillary Thyroid Microcarcinoma During Active Surveillance: Interim Analysis of a Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma in Korea

Lee

Moon

Hwangbo

et al. 2022

Thyroid

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Background: Active surveillance (AS) is an alternative to thyroidectomy for the management of low-risk papillary thyroid microcarcinoma (PTMC). However, prospective AS data collected from diverse populations are needed. Methods: This multicenter prospective cohort study enrolled patients from three referral hospitals in Korea. The participants were self-assigned into two groups, AS or immediate surgery. All patients underwent neck ultrasound every 6–12 months to monitor for disease progression. Progression under AS was evaluated by a criterion of tumor size increment by 3 mm in one dimension (3 mm), 2 mm in two dimensions (2 × 2 mm), new extrathyroidal extension (ETE), or new lymph node metastasis (LNM), and a composite outcome was defined using all four criteria. Results: A total of 1177 eligible patients with PTMC (919 female, 78.1%) with a median age of 48 years (range 19–87) were enrolled; 755 (64.1%) patients chose AS and 422 (35.9%) underwent surgery. Among 755 patients under AS, 706 (female 537, 76.1%) underwent at least two ultrasound examinations and were analyzed. Over a follow-up period of 41.4 months (standard deviation, 16.0), 163 AS patients (23.1%) underwent surgery. Progression defined by the composite outcome was observed in 9.6% (68/706) of patients, and the 2- and 5-year progression estimates were 5.3% and 14.2%, respectively. The observed progression rates were 5.8% (41/706) and 5.4% (38/706) as defined by tumor size enlargement by 3 mm and 2 × 2 mm, respectively, and 1.3% (9/706) and 0.4% (3/706) for new LNM and ETE, respectively. No distant metastases developed during AS. In multivariate logistic regression analysis examining variables associated with progression under AS, age at diagnosis <30 years (odds ratio [OR], 2.86; 95% confidence interval [CI], 1.10 − 7.45), male sex (OR, 2.48; 95% CI, 1.47 − 4.20), and tumor size ≥6 mm (OR, 1.89; 95% CI, 1.09 − 3.27) were independently significant. Conclusions: The progression of low-risk PTMC during AS in the Korean population was low, but slightly higher than previously reported in other populations. Risk factors for disease progression under AS include younger age, male sex, and larger tumor size. Clinical trial registration: NCT02938702.

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Section: Discussionsupporting

confidence: 89%

Progression of Low-Risk Papillary Thyroid Microcarcinoma During Active Surveillance: Interim Analysis of a Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma in Korea

Lee

Moon

Hwangbo

et al. 2022

Thyroid

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“…However, DTC among our males exhibited relatively more aggressive features (lymphovascular invasion, number of tumors, stage 4 disease, metastases) than among females. Such higher aggressiveness among males is congruent with other studies [ 30 ] and propositions of sex difference in TC pathogenesis [ 31 ].…”

Section: Discussionsupporting

confidence: 92%

Behaviour and epidemiology of differentiated thyroid cancer among filipinos in and outside the Philippines: Comparison between Qatar, Canada and Philippines

Ghali

Ansari

Abdelaal

et al. 2022

Annals of Medicine &Amp; Surgery

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“…L-Thyroxine (T 4 ), the prohormone exclusively secreted by the thyroid gland, ranks among the top five drugs prescribed by physicians [ 1 ] ( , accessed on 6 February 2023). Various forms of thyroid cancer are the most frequent malignancies of the endocrine system [ 2 ]. While nutritional iodine (I) supply markedly improved during the last few decades since the first introduction of table salt iodination programs in Switzerland and USA a century ago, various regions and countries on our globe still have not yet installed such preventive programs, or those measures taken by government and health organizations are insufficient, not well implemented and monitored, or only rely on voluntary behavior (Germany) [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Selenium, Iodine and Iron–Essential Trace Elements for Thyroid Hormone Synthesis and Metabolism

Köhrle

2023

IJMS

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The adequate availability and metabolism of three essential trace elements, iodine, selenium and iron, provide the basic requirements for the function and action of the thyroid hormone system in humans, vertebrate animals and their evolutionary precursors. Selenocysteine-containing proteins convey both cellular protection along with H2O2-dependent biosynthesis and the deiodinase-mediated (in-)activation of thyroid hormones, which is critical for their receptor-mediated mechanism of cellular action. Disbalances between the thyroidal content of these elements challenge the negative feedback regulation of the hypothalamus–pituitary–thyroid periphery axis, causing or facilitating common diseases related to disturbed thyroid hormone status such as autoimmune thyroid disease and metabolic disorders. Iodide is accumulated by the sodium-iodide-symporter NIS, and oxidized and incorporated into thyroglobulin by the hemoprotein thyroperoxidase, which requires local H2O2 as cofactor. The latter is generated by the dual oxidase system organized as ‘thyroxisome’ at the surface of the apical membrane facing the colloidal lumen of the thyroid follicles. Various selenoproteins expressed in thyrocytes defend the follicular structure and function against life-long exposure to H2O2 and reactive oxygen species derived therefrom. The pituitary hormone thyrotropin (TSH) stimulates all processes required for thyroid hormone synthesis and secretion and regulates thyrocyte growth, differentiation and function. Worldwide deficiencies of nutritional iodine, selenium and iron supply and the resulting endemic diseases are preventable with educational, societal and political measures.

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Sex Differences in Differentiated Thyroid Cancer

Cited by 56 publications

References 156 publications

Progression of Low-Risk Papillary Thyroid Microcarcinoma During Active Surveillance: Interim Analysis of a Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma in Korea

Progression of Low-Risk Papillary Thyroid Microcarcinoma During Active Surveillance: Interim Analysis of a Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma in Korea

Behaviour and epidemiology of differentiated thyroid cancer among filipinos in and outside the Philippines: Comparison between Qatar, Canada and Philippines

Selenium, Iodine and Iron–Essential Trace Elements for Thyroid Hormone Synthesis and Metabolism

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