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. 2021 Nov 3:12:759049.
doi: 10.3389/fendo.2021.759049. eCollection 2021.

Extranodal Extension Is an Independent Prognostic Factor in Papillary Thyroid Cancer: A Propensity Score Matching Analysis

Tian-Han Zhou  1 , Bei Lin  1 , Fan Wu  1 , Kai-Ning Lu  2 , Lin-Lin Mao  2 , Ling-Qian Zhao  1 , Ke-Cheng Jiang  1 , Yu Zhang  2 , Wei-Jun Zheng  3 , Ding-Cun Luo  2
Affiliations

Extranodal Extension Is an Independent Prognostic Factor in Papillary Thyroid Cancer: A Propensity Score Matching Analysis

Tian-Han Zhou et al. Front Endocrinol (Lausanne). .

Abstract

Purpose: To investigate the prognostic significance of extranodal extension (ENE) in papillary thyroid cancer (PTC).

Methods: Seven hundred forty-three PTC patients were enrolled in the study from January 2014 to December 2017. The patients were dichotomized according to the presence of ENE. Logistic analysis was used to compare differences between the two groups. Kaplan-Meier (K-M) curve and propensity score matching (PSM) analyses were used for recurrence-free survival (RFS) comparisons. Cox regression was performed to analyze the effects of ENE on RFS in PTC.

Results: Thirty-four patients (4.58%) had ENE. Univariate analysis showed that age, tumor size, extrathyroidal extension, and nodal stage were associated with ENE. Further logistic regression analysis showed that age, extrathyroidal extension, and nodal stage remained statistically significant. Evaluation of K-M curves showed a statistically significant difference between the two groups before and after PSM. Cox regression showed that tumor size and ENE were independent risk factors for RFS.

Conclusions: Age ≥55 years, extrathyroidal extension, and lateral cervical lymph node metastasis were identified as independent risk factors for ENE. ENE is an independent prognostic factor in PTC.

Keywords: extranodal extension; lymph node metastasis; papillary thyroid carcinoma; prognosis; propensity score matching; the real world.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Process of patient enrollment into the study cohort and included patients. ENE, extranodal extension; PTC, papillary thyroid carcinoma.
Figure 2
Figure 2
Anatomical diagram of extranodal extension in papillary thyroid cancer.
Figure 3
Figure 3
Comparison of recurrence-free survival of PTC patients before propensity score matching. ENE, extranodal extension; PTC, papillary thyroid carcinoma.
Figure 4
Figure 4
Comparison of recurrence-free survival of PTC patients after propensity score matching. ENE, extranodal extension; PTC, papillary thyroid carcinoma.
See this image and copyright information in PMC

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