We have located links that may give you full text access.
JOURNAL ARTICLE
RESEARCH SUPPORT, NON-U.S. GOV'T
Differentiated thyroid cancer presenting with distant metastases: a population analysis over two decades.
World Journal of Surgery 2013 July
BACKGROUND: Differentiated thyroid cancer (DTC) with distant metastases at presentation is uncommon; the prognosis of patients with this condition is more favorable than for other cancers. Demographic, clinical, and pathologic characteristics are described at a population level; factors associated with long-term disease-specific survival are identified.
METHODS: Patients were identified in the Surveillance, Epidemiology, and End Results (SEER) database between 1988 and 2009. They were divided into two groups: patients with distant metastases (met-DTC) and patients without distant metastases (DTC) at presentation. Data analyses were performed with chi square tests, ANOVA, Kaplan-Meier analysis, and binary logistic and Cox proportional hazards regression.
RESULTS: A total of 1,291 patients with met-DTC at diagnosis and 58,518 with DTC were included. The met-DTC rate was 2.2 %; compared to DTC, met-DTC patients were more often male (22.7 vs 41.3 %, respectively; p < 0.001) and older (mean 48.8 vs 62.7 years; p < 0.001). Patients with met-DTC were more likely not to have had surgery (23.3 vs 2.0 %; p < 0.001) or to have received radiation therapy (RAI) (66.8 vs 46.5 %; p < 0.001). Met-DTC tumors were larger (mean 41.0 vs 20.5 mm; p < 0.001). Independent factors associated with distant metastases were male gender, older age, single status, black and "other" races, follicular and Hurthle cell histology, larger tumors, and positive regional lymph nodes. Disease-specific survival was lower for met-DTC; this has not improved over the past two decades (p = 0.494). Independent factors associated with mortality included patient age ≥ 45 years, single status, follicular and Hurthle cell histologies, tumor size >4 cm, and not receiving surgery and/or RAI.
CONCLUSIONS: Overall, met-DTC is uncommon. Given the lack of survival improvement observed over the last two decades, novel treatments should be pursued aggressively for this subset of patients.
METHODS: Patients were identified in the Surveillance, Epidemiology, and End Results (SEER) database between 1988 and 2009. They were divided into two groups: patients with distant metastases (met-DTC) and patients without distant metastases (DTC) at presentation. Data analyses were performed with chi square tests, ANOVA, Kaplan-Meier analysis, and binary logistic and Cox proportional hazards regression.
RESULTS: A total of 1,291 patients with met-DTC at diagnosis and 58,518 with DTC were included. The met-DTC rate was 2.2 %; compared to DTC, met-DTC patients were more often male (22.7 vs 41.3 %, respectively; p < 0.001) and older (mean 48.8 vs 62.7 years; p < 0.001). Patients with met-DTC were more likely not to have had surgery (23.3 vs 2.0 %; p < 0.001) or to have received radiation therapy (RAI) (66.8 vs 46.5 %; p < 0.001). Met-DTC tumors were larger (mean 41.0 vs 20.5 mm; p < 0.001). Independent factors associated with distant metastases were male gender, older age, single status, black and "other" races, follicular and Hurthle cell histology, larger tumors, and positive regional lymph nodes. Disease-specific survival was lower for met-DTC; this has not improved over the past two decades (p = 0.494). Independent factors associated with mortality included patient age ≥ 45 years, single status, follicular and Hurthle cell histologies, tumor size >4 cm, and not receiving surgery and/or RAI.
CONCLUSIONS: Overall, met-DTC is uncommon. Given the lack of survival improvement observed over the last two decades, novel treatments should be pursued aggressively for this subset of patients.
Full text links
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app