Multifocal cancer is associated with better survival than solitary cancer in non-Hispanic White patients with thyroid carcinoma

Abstract

Background: Multifocal carcinoma is commonly reported in thyroid cancer. However, its impact on cancer survival is unclear. This study aims to evaluate whether multifocal disease is associated with better thyroid cancer outcomes in different ethnicities.

Methods: Cancer registration data in the US from 2000 to 2016 were obtained via the Surveillance, Epidemiology, and End Results (SEER) 18 Registries database. Patients diagnosed with thyroid carcinoma and without other malignancies were enrolled. Univariable and multivariable Cox regressions were applied to evaluate the association of multifocal disease with cancer-specific survival (CSS) and overall survival (OS). Multivariable analyses were performed after adjusting for age, gender, stage, and treatment.

Results: A total of 82,217, 8,551, 13,445, and 19,558 non-Hispanic White (NHW), non-Hispanic African American (AA), non-Hispanic Asian or Pacific Islander (AP), and Hispanic White (HW) patients were enrolled in this study, respectively. Univariable analysis suggested that multifocal carcinoma would have significant better CSS [hazard ratio (HR) =0.89, 95% confidence interval (CI): 0.77-1.02, P=0.09; adjusted HR =0.67, 95% CI: 0.53-0.85, P<0.001] and OS (HR =0.83, 95% CI: 0.77-0.90, P<0.001; adjusted HR =0.76, 95% CI: 0.65-0.87, P<0.001) than solitary disease in NHW.

Conclusions: Multifocal thyroid carcinoma is associated with better CSS and OS than solitary cancer in NHW patients.

Keywords: Caucasian; Multifocal; Surveillance, Epidemiology, and End Results (SEER); solitary; thyroid cancer.