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Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer
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Predicting distant metastatic disease in differentiated thyroid cancer: a matched case-control study.

Sukaina Jaffar1,2, Jayani Jayasekara1,2, Ahmad M Aniss1

  • 1Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia.

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|February 16, 2021
PubMed
Summary

Distant metastasis (DM) in differentiated thyroid cancer (DTC) is linked to poorer survival. Extra-thyroidal extension, lymph node involvement, and BRAFV600E mutation in papillary thyroid cancer predict DM development.

Keywords:
differentiated thyroid cancerdisease-specific survivaldistant metastasisoverall survivalrisk factors

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Area of Science:

  • Oncology
  • Endocrinology
  • Surgical Oncology

Background:

  • Distant metastasis (DM) is a critical prognostic factor in differentiated thyroid cancer (DTC).
  • Early identification of patients at risk for DM is crucial for optimal treatment strategies.
  • While uncommon (1-9%), DTC incidence is rising, particularly in younger populations.

Purpose of the Study:

  • To identify predictive factors for DM development in DTC.
  • To compare clinical and molecular characteristics of DTC patients with and without DM.
  • To report survival outcomes for DTC patients presenting with DM.

Main Methods:

  • A matched case-control study involving 2547 DTC patients treated between 1968-2014.
  • Cases (n=83) had DM at presentation; controls were matched for age, gender, tumor size, and histology.
  • Outcomes included overall survival, disease-specific survival (DSS), lymph node involvement (LNI), extra-thyroidal extension (ETE), and BRAFV600E mutation status.

Main Results:

  • DTC patients with DM at presentation (DTC-DM) had significantly higher rates of ETE (63% vs. 29.5%) and LNI (32.5% vs. 18.8%).
  • Five and 10-year overall survival rates for DTC-DM patients were 89.6% and 64%, respectively.
  • BRAFV600E mutation in papillary thyroid cancer (PTC) was significantly associated with DM (62.2% vs. 36.8%).

Conclusions:

  • Extra-thyroidal extension (ETE) and lymph node involvement (LNI) are significant predictors of DM in DTC.
  • BRAFV600E mutation is a key predictor for DM in papillary thyroid cancer (PTC).
  • These findings aid in risk stratification and personalized treatment approaches for DTC.