悪性黒色腫様甲状腺癌における腫瘍径およびリンパ節関与のデータ駆動型閾値：集団ベースの分析
Milanie Milan1, Samantha M Thomas2, Christina V Lindsay1
1Department of Surgery, Duke University Medical Center, Durham, NC, USA.
Introduction:
We sought to identify prognostically meaningful thresholds for tumor size and lymph node (LN) metastasis as a first step toward developing a dedicated staging system for oncocytic thyroid carcinoma (OTC).
Methods:
Using SEER (2004-2022), tumor size and LN thresholds for OTC were analyzed using restricted cubic splines; Cox models estimated association with overall (OS) and disease-specific survival (DSS).
Results:
Among 4114 patients, median tumor size was 34 mm, and 1410 (34.3%) had ≥1 LN examined. Tumor size showed a linear relationship with OS and DSS (no prognostic threshold). LN positivity showed thresholds of 2.42 positive LNs for OS and 2.14 for DSS; thus, ≥3 positive LNs was considered a prognostic threshold. Patients with ≥3 vs < 3 positive LNs had lower adjusted DSS (HR 3.32; p < 0.001) and OS (HR 2.65; p < 0.001).
Conclusion:
For OTC, ≥3 positive LNs constituted a prognostic threshold, while tumor size conferred continuous risk.
