Tree-Based Model for Thyroid Cancer Prognostication

Banerjee, Mousumi; Muenz, Daniel; Chang, Jongwha; Papaleontiou, Maria; Haymart, Megan R.

doi:10.1210/jc.2014-2197

Cited by 54 publications

(39 citation statements)

References 28 publications

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“…Although CART has been used in clinical research, tree-based approaches have been largely underutilized within observational epidemiology. 31,32 Although variations in body composition across racial and ethnic groups are well established, 36 this is the first study to examine racial differences in muscle weakness in diverse sample of older American adults. However, it should be noted that even though the replication of previous work by FNIH was carried out in this analysis, using slow walking speed as the primary outcome variable in the CART models may not have been ideal, particularly for black men and women, given the high prevalence of slow walking speed in the sample.…”

Section: Discussionmentioning

confidence: 99%

Cut Points for Clinical Muscle Weakness Among Older Americans

Duchowny

Peterson

Clarke

2017

American Journal of Preventive Medicine

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Introduction Muscle weakness is an important indicator of disability, chronic disease, and early mortality. Grip strength is a simple, cost-effective measure of overall muscle strength. The Foundation of the National Institutes of Health (FNIH) recently proposed sex-specific grip strength cut points for clinical muscle weakness. However, these criteria were established using non–nationally representative data. This study used nationally representative data on Americans aged ≥65 years to identify race- and sex-specific cut points for clinical muscle weakness and quantify prevalence among older blacks and whites by sex. Methods Classification and Regression Tree models were used to identify cut points based on individual-level grip strength associated with slow gait speed (<0.8 m/second) among 7,688 individuals (57% female; 8% black; mean age, 74.6 [SD=6.79] years) from the 2010/2012 Health and Retirement Study during January–April 2016. Identified cut points were then used to quantify the prevalence of weakness by race/sex subgroup. Results Fifty-five percent of men (max grip strength <39 kg) and 47% of women (<22 kg) were classified as weak. Higher cut points were identified for black men (<40 kg) and women (<31 kg), and the prevalence of weakness (57% and 88%, respectively), was higher compared with whites. Fifty-five percent of individuals had slow gait speed (<0.8 m/s). Conclusions Prevalence of weakness was substantially higher than previous reports, underscoring the importance of using population-level data to identify individuals at greatest risk for adverse health outcomes. This is the first study to establish cut points for muscle weakness in a nationally representative sample by race and sex.

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Section: Discussionmentioning

confidence: 99%

Cut Points for Clinical Muscle Weakness Among Older Americans

Duchowny

Peterson

Clarke

2017

American Journal of Preventive Medicine

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“…Patients with distant metastatic disease at presentation have a 50% rate of 5-year survival mainly because of the sensitivity of metastatic disease to RAI therapy [1,4]. Age at diagnosis has a strong effect on survival; patients aged ,51 years have a .90% rate of 10-year survival, even with distant disease detected at time of diagnosis [5]. It is estimated that 20% of patients with locoregional disease at presentation will develop distant metastasis at some point in their lifetimes [6].…”

Section: Introductionmentioning

confidence: 99%

Differentiated Thyroid Cancer: Focus on Emerging Treatments for Radioactive Iodine-Refractory Patients

Gruber

Colevas

2015

The Oncologist

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Background. The treatment of differentiated thyroid cancer refractory to radioactive iodine (RAI) had been hampered by few effective therapies. Recently, tyrosine kinase inhibitors (TKIs) have shown activity in this disease. Clinical guidance on the use of these agents in RAI-refractory thyroid cancer is warranted. Materials and Methods. Molecular mutations found in RAIrefractory thyroid cancer are summarized. Recent phase II and III clinical trial data for TKIs axitinib, lenvatinib, motesanib, pazopanib, sorafenib, sunitinib, and vandetinib are reviewed including efficacy and side effect profiles. Molecular targets and potencies of these agents are compared. Inhibitors of BRAF, mammalian target of rapamycin, and MEK are considered.

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“…28,29 Ghaznavi et al reported that the, "Integration of the AJCC stage, ATA risk, and age groups identified six subgroups with differing outcomes: (i) stage I/ATA low-risk, younger and older, 100.0% DSS; (ii) stage I/ATA intermediate-risk, younger and older, 98% DSS; (iii) stage I/ATA high-risk, younger, 95% DSS; (iv) stage I/ATA high-risk, older, 89% DSS; (v) stage II/ATA highrisk, younger, 78% DSS; and (vi) stage II/ATA high-risk, older, 61% DSS." 30,31 Lim et al reported that patients treated with a total thyroidectomy had an increased RFS when compared to those treated with lobectomy with isthmusectomy (hazard ratio: 0.355; 95% CI: 0.127-0.992). Other studies also report the 10-year DSS of the low-risk WDTC to be 95% to 100.0%.…”

Section: Discussionmentioning

confidence: 99%

Isthmusectomy in selected patients with well‐differentiated thyroid carcinoma

et al. 2019

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Background: Isthmusectomy in the treatment of well-differentiated thyroid carcinoma (WDTC) is controversial. In this study, we analyze the outcomes of WDTC managed by isthmusectomy alone. Methods: Forty-three patients treated with isthmusectomy alone were identified from an institutional database of 6259 surgically treated patients with WDTC. Patient and tumor characteristics were analyzed. Disease-specific survival (DSS) and recurrence-free survival (RFS) were calculated using the Kaplan-Meier method. Results: The pT classification was T1 for 41 and T2 for two patients. All were clinical N0, but 10 pts were pN1a. Using the American Thyroid Association risk stratification system, 9 patients were low-risk and 22 were intermediate-risk. One patient developed local recurrence, and two developed regional lymph node metastases; the 5-and 10-year DSS was 100.0%. The 5-and 10-year RFS was 93.1%. Conclusions: Isthmusectomy alone is an acceptable procedure in selected patients with low-and intermediate-risk WDTC limited to the isthmus. K E Y W O R D Sisthmectomy, isthmus, isthmusectomy, low risk cancer, well-differentiated thyroid carcinoma

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Tree-Based Model for Thyroid Cancer Prognostication

Abstract: This study identifies distinct prognostic groups for thyroid cancer and illustrates the importance of patient age to both disease-specific and OS. These findings have implications for patient education and thyroid cancer treatment.

Cited by 54 publications

References 28 publications

Cut Points for Clinical Muscle Weakness Among Older Americans

Cut Points for Clinical Muscle Weakness Among Older Americans

Differentiated Thyroid Cancer: Focus on Emerging Treatments for Radioactive Iodine-Refractory Patients

Isthmusectomy in selected patients with well‐differentiated thyroid carcinoma

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