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Stage II Differentiated Thyroid Cancer Is a High-Risk Disease in Patients <45/55 Years Old.


ABSTRACT: PURPOSE:The mortality risk of stage II differentiated thyroid cancer (DTC) based on the American Joint Committee on Cancer (AJCC) staging system requires further investigation. METHODS:Retrospective study of DTC in the US Surveillance, Epidemiology, and End Results program for disease-specific mortality risk in various AJCC stages, with patient age stratification of stage II disease. RESULTS:Using AJCC staging system 6.0, hazard ratios (HRs) of mortality for stage II DTC in patients <45 yo and patients ?45 yo and stages III, IVA, IVB, and IVC compared with stage I were 46.95, 4.95, 9.82, 57.37, 222.10, and 468.68, respectively, showing a robustly higher mortality risk in stage II disease in patients <45 yo than in older patients (P < 0.001), comparable with stage IVA (P = 0.482). Similar results were obtained with AJCC 7.0. With AJCC 8.0, HRs of mortality for stage II in patients <55 yo and patients ?55 yo and stages III, IVA, and IVB compared with stage I were 75.16, 11.23, 69.45, 134.94, and 235.70, respectively, showing a robustly higher risk in stage II disease in patients <55 yo than in older patients (P < 0.001), comparable with stage III (P = 0.57). Kaplan-Meier survival curves displayed a sharp decline with stage II disease in patients <45/55 yo compared with older patients. CONCLUSIONS:The mortality risk of stage II DTC was sharply differentiated at patient age 45/55 years, being robustly high in younger patients and comparable with stage III/IVA. This emphasizes the importance of considering age when managing stage II DTC and not treating it as a uniformly low-risk disease.

SUBMITTER: Liu Z 

PROVIDER: S-EPMC7453036 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Stage II Differentiated Thyroid Cancer Is a High-Risk Disease in Patients <45/55 Years Old.

Liu Zeming Z   Shen Xiaopei X   Liu Rengyun R   Zhu Guangwu G   Huang Tao T   Xing Mingzhao M  

The Journal of clinical endocrinology and metabolism 20191101 11


<h4>Purpose</h4>The mortality risk of stage II differentiated thyroid cancer (DTC) based on the American Joint Committee on Cancer (AJCC) staging system requires further investigation.<h4>Methods</h4>Retrospective study of DTC in the US Surveillance, Epidemiology, and End Results program for disease-specific mortality risk in various AJCC stages, with patient age stratification of stage II disease.<h4>Results</h4>Using AJCC staging system 6.0, hazard ratios (HRs) of mortality for stage II DTC in  ...[more]

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