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Multifocality as a prognostic factor in thyroid cancer: A meta-analysis.

Kyle R Joseph1, Senarath Edirimanne1, Guy D Eslick2

  • 1Department of Endocrine Surgery, Nepean Hospital, Penrith, New South Wales, Australia.

International Journal of Surgery (London, England)
|January 17, 2018
PubMed
Summary

Multifocality in thyroid cancer is linked to increased risks of lymph node metastasis, extrathyroidal extension, and disease recurrence. Aggressive management is recommended for patients with multifocal thyroid cancer.

Keywords:
Distant metastasesExtrathyroidal extensionLymph node metastasisMultifocalRecurrenceThyroid cancer

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Area of Science:

  • Endocrinology
  • Oncology
  • Pathology

Background:

  • Thyroid cancer incidence is rising globally.
  • Multifocality in thyroid cancer is suspected to correlate with poorer patient outcomes.
  • This meta-analysis quantifies multifocality as a prognostic indicator.

Purpose of the Study:

  • To systematically evaluate multifocality as a risk factor for poor prognosis in thyroid cancer.
  • To perform a meta-analysis on existing data regarding multifocality and thyroid cancer outcomes.
  • To identify specific prognostic factors associated with multifocal thyroid cancer.

Main Methods:

  • Systematic literature search of PubMed and Medline databases.
  • Inclusion of studies on multifocality, thyroid cancer, and prognostic factors (e.g., lymph node metastases, extrathyroidal extension, recurrence).
  • Comparative analysis of hazard ratios and odds ratios from 21 selected articles.

Main Results:

  • Multifocality significantly increases the risk of lymph node metastases (OR=1.87) and extrathyroidal extension (OR=3.18).
  • Tumor size greater than 1 cm (OR=2.75) and disease recurrence (HR=2.81) are also associated with multifocality.
  • Age >45 and male gender were not significant risk factors for multifocality.

Conclusions:

  • Multifocality is a significant predictor of thyroid cancer progression and recurrence.
  • Patients with multifocal thyroid cancer require more aggressive surgical and post-operative management.
  • Findings support the clinical importance of identifying multifocality for improved patient care.