Taciana Padilha de Castro1,2, William Waissmann2, Taynãna César Simões3, Rossana Corbo R de Mello1,4, Denise P Carvalho1,5. 1. Department of Endocrinology, Medical School, Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brazil. 2. Research Center for Health Work and Human Ecology - CESTEH-ENSP/FIOCRUZ, Rio de Janeiro, RJ, Brazil. 3. Department of Epidemiology and Quantitative Methods in Health - DEMQS-ENSP/FIOCRUZ, Rio de Janeiro, RJ, Brazil. 4. Cancer Hospital 1, National Institute of Cancer INCA, Rio de Janeiro, RJ, Brazil. 5. Carlos Chagas Filho Institute of Biophysics - IBCCF/UFRJ, Rio de Janeiro, RJ, Brazil.
Abstract
OBJECTIVE: We aimed to determine outcome predictors of papillary thyroid cancer (PTC) persistence and recurrence, separately. CONTEXT: The factors contributing to either persistence or recurrence of PTC are poorly defined, as both outcomes are usually evaluated together. DESIGN AND PATIENTS: In this 10-year follow-up cohort study, 190 PTC patients were evaluated (18-85 years old; registered from 1 January 1990 to31 December 1999 at a Brazilian Cancer Care referral Hospital). After initial surgery, we examined persistence (disease detected up to 1 year), recurrence (disease detected after 1 year) and PTC-free status (disease absence during follow-up). MEASUREMENTS: Outcome predictors were modelled using multinomial logit regression analysis. RESULTS: The univariate analysis showed that persistence and recurrence were significantly associated with lymph node metastasis (OR = 12·33; OR = 2·84, respectively), local aggressiveness (OR = 5·22; OR = 3·35) and extrathyroidal extension (OR = 5·07; OR = 7·11). Persistence was associated with male sex (OR = 3·49), age above 45 years old at diagnosis (OR = 1·03), macroscopic lymph node metastasis (OR = 5·85), local aggressiveness (OR = 5·22), each 1-cm tumour size increase (OR = 1·34), a cancer care referral hospital as the place of initial surgery (OR = 2·3), thyroidectomy or near total thyroidectomy(OR = 3·03) and neck dissection (OR = 3·19). Recurrence was associated with the time of radioactive iodine ((131) I) therapy (OR = 3·71). After data modelling, persistence was associated with macroscopic lymph node metastasis (OR = 6·17), 1-cm increases in tumour size (OR = 1·30) and thyroidectomy or near total thyroidectomy (OR = 3·82), while recurrence was associated with surgery at referral hospital (OR = 3·79). CONCLUSIONS: The best predictors of persistence were tumour size and macroscopic lymph node metastasis; when the initial surgery is of quality, the recurrence depends more on tumour's biology aspects.
OBJECTIVE: We aimed to determine outcome predictors of papillary thyroid cancer (PTC) persistence and recurrence, separately. CONTEXT: The factors contributing to either persistence or recurrence of PTC are poorly defined, as both outcomes are usually evaluated together. DESIGN AND PATIENTS: In this 10-year follow-up cohort study, 190 PTC patients were evaluated (18-85 years old; registered from 1 January 1990 to31 December 1999 at a Brazilian Cancer Care referral Hospital). After initial surgery, we examined persistence (disease detected up to 1 year), recurrence (disease detected after 1 year) and PTC-free status (disease absence during follow-up). MEASUREMENTS: Outcome predictors were modelled using multinomial logit regression analysis. RESULTS: The univariate analysis showed that persistence and recurrence were significantly associated with lymph node metastasis (OR = 12·33; OR = 2·84, respectively), local aggressiveness (OR = 5·22; OR = 3·35) and extrathyroidal extension (OR = 5·07; OR = 7·11). Persistence was associated with male sex (OR = 3·49), age above 45 years old at diagnosis (OR = 1·03), macroscopic lymph node metastasis (OR = 5·85), local aggressiveness (OR = 5·22), each 1-cm tumour size increase (OR = 1·34), a cancer care referral hospital as the place of initial surgery (OR = 2·3), thyroidectomy or near total thyroidectomy(OR = 3·03) and neck dissection (OR = 3·19). Recurrence was associated with the time of radioactive iodine ((131) I) therapy (OR = 3·71). After data modelling, persistence was associated with macroscopic lymph node metastasis (OR = 6·17), 1-cm increases in tumour size (OR = 1·30) and thyroidectomy or near total thyroidectomy (OR = 3·82), while recurrence was associated with surgery at referral hospital (OR = 3·79). CONCLUSIONS: The best predictors of persistence were tumour size and macroscopic lymph node metastasis; when the initial surgery is of quality, the recurrence depends more on tumour's biology aspects.
Authors: Ricardo Cortez Cardoso Penha; Luisa Aguirre Buexm; Fabiana Resende Rodrigues; Taciana Padilha de Castro; Maria Carolina S Santos; Rodrigo Soares Fortunato; Denise P Carvalho; Luciene C Cardoso-Weide; Andrea C F Ferreira Journal: BMC Cancer Date: 2018-05-02 Impact factor: 4.430
Authors: Olfat Kamel Hasan; Sarah De Brabandere; Irina Rachinsky; David Laidley; Danielle MacNeil; Stan Van Uum Journal: J Thyroid Res Date: 2020-01-10