Bilateral multifocality, a marker for aggressive disease, is not an independent prognostic factor for papillary thyroid microcarcinoma: A propensity score matching analysis

2021 ◽  
Author(s):  
Ting Yan ◽  
Wangwang Qiu ◽  
Jianlu Song ◽  
Tao Ying ◽  
Youben Fan ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Independent Prognostic Factor ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Propensity Score Matching Analysis ◽  
Aggressive Disease ◽  
Thyroid Microcarcinoma

scholarly journals Extent of Surgery and the Prognosis of Unilateral Papillary Thyroid Microcarcinoma

2021 ◽  
Vol 12 ◽  
Author(s):  
Hengqiang Zhao ◽  
Le Cui
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Distant Metastasis ◽  
Cox Regression ◽  
Extrathyroidal Extension ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Thyroid Microcarcinoma ◽  
Kaplan Meier ◽  
Extent Of Surgery

It remains controversial whether patients with papillary thyroid microcarcinoma (PTMC) benefit from total thyroidectomy (TT) or thyroid lobectomy (TL). We aimed to investigate the impact of extent of surgery on the prognosis of patients with unilateral PTMC. Patients were obtained from the Surveillance, Epidemiology, and End Results database from 2004 to 2015. Cancer-specific survival (CSS) and overall survival (OS) were evaluated by Cox regression and Kaplan–Meier curves with propensity score matching. Of 31167 PTMC patients enrolled, 22.2% and 77.8% of which underwent TL and TT, respectively. Patients with TT were more likely to be younger, females, present tumors of multifocality, extrathyroidal extension, cervical lymph node metastasis (CLNM), distant metastasis, and receive radioactive iodine (RAI) compared with those receiving TL. The multivariate Cox regression model showed that TT was not associated with an improved CSS and OS compared with TL with hazard ratio (HR) and 95% confidence interval (CI) of 0.53 (0.25-1.12) and 0.86 (0.72-1.04), respectively. In addition, the Kaplan–Meier curves further confirmed the similar survival between TL and TT after propensity score matching. The subgroup analysis showed that TT was associated with better CSS for patients < 55 years, those with tumors of gross extrathyroidal extension, CLNM (N1b), and cases not receiving RAI with HR 95% CI of 0.13 (0.02-0.81), 0.12 (0.02-0.66), 0.11 (0.02-0.64) and 0.36 (0.13-0.90), respectively. TT predicted a trend of better OS for patients with N1b and distant metastasis after adjustment. In addition, TT was associated with better CSS than TL for patients with risk factors like N1b combined with gross extrathyroidal extension, and/or multifocality after matching. In conclusion, TL may be enough for low-risk PTMC patients. TT may improve the prognosis of unilateral PTMC patients with 2 or more risk clinicopathologic factors like CLNM, multifocality, extrathyroidal extension and a younger age compared with TL.

scholarly journals Marital Status is an Independent Prognostic Factor in 7 Sites of Squamous Cell Carcinoma: A Propensity-Adjusted SEER Database Analysis

2021 ◽  
Author(s):  
Ji-li Xu ◽  
Yong Guo
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prognostic Factor ◽  
Propensity Score ◽  
Marital Status ◽  
Cell Carcinoma ◽  
Propensity Score Matching ◽  
Squamous Cell ◽  
Cox Regression ◽  
Independent Prognostic Factor ◽  
Seer Database

Abstract Background: Marital status has been proved as an independent prognostic factor in many cancer types. However, no detailed investigation of marital status on squamous cell carcinoma (SCC) has been evaluated. The aim of this essay is to explore the relationship between marital status and SCC in 7 tumor sites. Methods: All patients diagnosed with SCC were collected from the SEER database (1975-2016). We analyzed the survival of all included SCC patients in four marital status. We utilized propensity-score matching analysis to balance baseline characteristics between married and unmarried SCC patients in 7 tumor sites. The influence of marital status on overall survival (OS) in each site was performed by Cox regression analysis.Results: A total of 180009 SCC patients were involved in this study. After propensity-score matching, patients in the married group were 1:1 matched with patients in the unmarried group for each sites. Married group exhibited higher 5- year OS rate than unmarried group (27.3% vs 19.8%). More precisely, being divorced and widowed were observed to be related to have worse survival than single patients in most sites. Furthermore, patients with clinical stage IV were more common in the unmarried group which having a lower proportion of receiving treatment. Conclusions: This study indicated that marital status was a significant factor for OS of SCC in 7 tumor sites. Married patients always behaved more favorable than unmarried including single, divorced, and widowed patients.

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