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. 2020 Dec 3;12(12):3624.
doi: 10.3390/cancers12123624.

Annual Hazard Rate of Recurrence in Middle Eastern Papillary Thyroid Cancer over a Long-Term Follow-Up

Abdul K Siraj  1 , Sandeep Kumar Parvathareddy  1 , Zeeshan Qadri  1 , Khawar Siddiqui  2 , Saif S Al-Sobhi  3 , Fouad Al-Dayel  4 , Khawla S Al-Kuraya  1
Affiliations

Annual Hazard Rate of Recurrence in Middle Eastern Papillary Thyroid Cancer over a Long-Term Follow-Up

Abdul K Siraj et al. Cancers (Basel). .

Abstract

Predicting the pattern of recurrence in papillary thyroid cancer (PTC) is necessary to establish optimal surveillance and treatment strategies. We analyzed changes in hazard rate (HR) for tumor recurrence over time in 1201 unselected Middle Eastern PTC patients. The changes in risk were further analyzed according to clinical variables predictive of early (≤5 years) and late (>5 years) recurrence using Cox regression analysis to identify patient populations that remain at risk. Tumor recurrence was noted in 18.4% (221/1201) patients. The annualized hazard of PTC recurrence was highest during the first 5 years (2.8%), peaking between 1 and 2 years (3.7%), with a second smaller peak between 13 and 14 years (3.2%). Patients receiving radioactive iodine (RAI) therapy had lower recurrence hazard compared to those who did not (1.5% vs. 2.7%, p = 0.0001). Importantly, this difference was significant even in intermediate-risk PTC patients (0.7% vs. 2.3%; p = 0.0001). Interestingly, patients aged ≥55 years and having lymph node metastasis were at persistent risk for late recurrence. In conclusion, we confirmed the validity of the double-peaked time-varying pattern for recurrence risk in Middle Eastern PTC patients and our findings could help in formulating individualized treatment and surveillance plans.

Keywords: annual hazard; papillary thyroid cancer; radioactive iodine; recurrence; time-varying.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Annual hazard rate of cancer recurrence for the (A) entire population and (B) different risk classes.
Figure 2
Figure 2
Annual hazard rate of cancer recurrence in the entire cohort according to RAI status.
Figure 3
Figure 3
Annual hazard rate of cancer recurrence in the intermediate risk PTC according to RAI status.
See this image and copyright information in PMC

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