Min Ji Jeon1, Hee Kyung Kim2, Eun Heui Kim3, Eun Sook Kim4, Hyon-Seung Yi5, Tae Yong Kim1, Ho-Cheol Kang2, Young Kee Shong1, Won Bae Kim1, Bo Hyun Kim3, Won Gu Kim1. 1. 1 Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea. 2. 2 Department of Internal Medicine, Chonnam National University Medical School , Gwangju, Korea. 3. 3 Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital , Busan, Korea. 4. 4 Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine , Ulsan, Korea. 5. 5 Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine , Daejeon, Korea.
Abstract
BACKGROUND: Recent studies have reported improved survival in patients with thyroid cancer. This study evaluated the changes in disease-specific survival (DSS) of patients with differentiated thyroid cancer (DTC) in association with clinicopathologic characteristics from 1996 to 2005 in Korea. METHODS: This was a retrospective, multicenter cohort study. A total of 4398 DTC patients were included, and they were classified according to the year of initial surgery: 1996-2000 (period 1), 2001-2003 (period 2), and 2004-2005 (period 3). RESULTS: During the study period, patient age and the proportion of papillary thyroid cancer increased gradually. Primary tumors became smaller (2.3 ± 1.4 cm at period 1 to 1.5 ± 1.2 cm at period 3; p < 0.001). The proportion of high-volume lymph node metastases decreased significantly (20% at period 1 to 13% at period 3; p for trend <0.001). DSS differed significantly according to period during the median 10 years follow-up (p = 0.002). The 10-year DSS rates were 98.0%, 98.7%, and 99.2% in periods 1, 2, and 3, respectively. After adjusting for various characteristics, the disease-specific mortality risk was significantly lower during period 2 (hazard ratio = 0.49 [confidence interval CI 0.25-0.90], p = 0.021) and period 3 (hazard ratio = 0.40 [confidence interval 0.21-0.77], p = 0.006) compared to that of period 1. This trend was also significant in a subgroup analysis of low (I-II) and high (III-IV) TNM stages. CONCLUSIONS: The disease-specific mortality of patients with DTC in Korea decreased over time. Earlier detection of small DTCs with less extensive disease and standardization of treatment may be associated with this phenomenon.
BACKGROUND: Recent studies have reported improved survival in patients with thyroid cancer. This study evaluated the changes in disease-specific survival (DSS) of patients with differentiated thyroid cancer (DTC) in association with clinicopathologic characteristics from 1996 to 2005 in Korea. METHODS: This was a retrospective, multicenter cohort study. A total of 4398 DTC patients were included, and they were classified according to the year of initial surgery: 1996-2000 (period 1), 2001-2003 (period 2), and 2004-2005 (period 3). RESULTS: During the study period, patient age and the proportion of papillary thyroid cancer increased gradually. Primary tumors became smaller (2.3 ± 1.4 cm at period 1 to 1.5 ± 1.2 cm at period 3; p < 0.001). The proportion of high-volume lymph node metastases decreased significantly (20% at period 1 to 13% at period 3; p for trend <0.001). DSS differed significantly according to period during the median 10 years follow-up (p = 0.002). The 10-year DSS rates were 98.0%, 98.7%, and 99.2% in periods 1, 2, and 3, respectively. After adjusting for various characteristics, the disease-specific mortality risk was significantly lower during period 2 (hazard ratio = 0.49 [confidence interval CI 0.25-0.90], p = 0.021) and period 3 (hazard ratio = 0.40 [confidence interval 0.21-0.77], p = 0.006) compared to that of period 1. This trend was also significant in a subgroup analysis of low (I-II) and high (III-IV) TNM stages. CONCLUSIONS: The disease-specific mortality of patients with DTC in Korea decreased over time. Earlier detection of small DTCs with less extensive disease and standardization of treatment may be associated with this phenomenon.
Authors: Abdelrahman Abdelaal; Walid El Ansari; Abdelrahman Abusabeib; Hanan Farghaly; Abdelhakem A M Tabeb Journal: Int J Surg Case Rep Date: 2020-06-20
Authors: Hosu Kim; So Young Park; Jaehoon Jung; Jung-Han Kim; Soo Yeon Hahn; Jung Hee Shin; Young Lyun Oh; Man Ki Chung; Hye In Kim; Sun Wook Kim; Jae Hoon Chung; Tae Hyuk Kim Journal: Sci Rep Date: 2019-12-10 Impact factor: 4.379