Clinical Risk Factor for Detected Distant Metastasis and Anaplastic Transformation After Reoperation in...

Area of Science:

• Endocrinology
• Oncology
• Surgical Oncology

Background:

• Recurrent/persistent differentiated thyroid cancer poses challenges, with limited research on distant metastasis or anaplastic transformation post-reoperation.
• Understanding risk factors is crucial for managing these advanced cases.

Purpose of the Study:

• To identify clinical factors associated with distant metastasis or anaplastic transformation following reoperation in differentiated thyroid cancer patients.
• To inform risk stratification and treatment strategies for recurrent thyroid cancer.

Main Methods:

• Retrospective review of 336 patients undergoing reoperation for differentiated thyroid cancer.
• Analysis of clinical factors and estimation of hazard ratios (HRs) and 95% confidence intervals (CIs) for distant metastasis and anaplastic transformation.

Main Results:

• Distant metastasis detected in 13.4% of patients; risk increased with male sex, age ≥55, initial T3-4 stage, in-field recurrence, and ≥3 reoperations.
• Anaplastic transformation detected in 2.1% of patients; risk increased with age ≥55 and ≥3 reoperations.

Conclusions:

• Distant metastasis and anaplastic transformation are significant concerns in recurrent differentiated thyroid cancer post-reoperation.
• Identifying high-risk patients (men, ≥55 years, initial T3-4 stage, multiple reoperations) is vital for tailored management.