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. 2022 Mar 1:13:791826.
doi: 10.3389/fendo.2022.791826. eCollection 2022.

Risk Factors and Prognosis for Metastatic Follicular Thyroid Cancer

Ming-Hsien Wu  1   2   3 , Yi-Yin Lee  1   2   3 , Yu-Ling Lu  1   2   3 , Shu-Fu Lin  1   2   3
Affiliations

Risk Factors and Prognosis for Metastatic Follicular Thyroid Cancer

Ming-Hsien Wu et al. Front Endocrinol (Lausanne). .

Abstract

Background: Follicular thyroid cancer (FTC) is the second most common malignancy of thyroid. About 7%-23% of patients with FTC have distant metastasis. The aim of this study was to investigate the risk factors associated with distant metastasis and the impact of distant metastasis on survival in FTC patients.

Methods: Patients with FTC were analyzed using a prospectively maintained dataset of thyroid cancer registered at a tertiary hospital in Taiwan between December 1976 and May 2020.

Results: A total of 190 patients with a mean follow-up of 7.7 years were included in this study, including 29 with distant metastasis at diagnosis, 14 who developed metastasis during follow-up, and 147 without metastasis. Multivariate analysis adjusted for age, gender, tumor stage, and extrathyroidal invasion revealed old age (≥ 55 years) (adjusted odds ratio, 27.6; 95% confidence interval [CI], 8.75-86.8; P < 0.001) and extrathyroidal invasion (odds ratio, 24.1; 95% CI, 3.50-166.5; P = 0.001) were significantly associated with an increased risk of distant metastasis. Metastasis was correlated with higher cancer-specific mortality (adjusted hazard ratio, 35.5; 95% CI, 6.1-206.1; P < 0.001). In addition, patients with metastatic FTC diagnosed on initial presentation had the lowest 10-year cancer-specific survival rate (26.0%), followed by those who developed metastatic disease after initial treatment (76.6%), while patients without metastasis were all alive (100%) (P ≤ 0.002 for all comparisons).

Conclusions: Age and extrathyroidal invasion are significant risk factors for distant metastasis of FTC. Patients with metastatic FTC, especially when diagnosed on initial presentation, have dismal survival outcomes.

Keywords: cancer-specific survival; distant metastasis; follicular thyroid cancer (FTC); prognosis; risk factors.

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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
Flowchart of cohort establishment.
Figure 2
Figure 2
Kaplan–Meier plots illustrating cancer-specific survival of FTC patients. (A) Kaplan–Meier survival plots for patients with metastatic FTC at presentation (M1), developing metastasis during follow-up (M2), and with no evidence of metastasis (M0). (B) Kaplan–Meier survival plots for FTC patients with stage I, II, and III/IV disease at diagnosis.
See this image and copyright information in PMC

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