Evidence map›Paper›PMID 29445865›Full record

ArticleLangenbeck's archives of surgery2018

Risk of recurrence in a homogeneously managed pT3-differentiated thyroid carcinoma population.

Nathalie Chereau, Etienne Dauzier, Gaëlle Godiris-Petit, Séverine Noullet, Isabelle Brocheriou, Laurence Leenhardt, Camille Buffet, Fabrice Menegaux

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In one paragraph

Article in Langenbeck's archives of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Nathalie ChereauDepartment of General, Visceral, and Endocrine Surgery, Pitié Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France. nathalie.chereau@aphp.fr.
Etienne DauzierDepartment of General, Visceral, and Endocrine Surgery, Pitié Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France.
Gaëlle Godiris-PetitDepartment of General, Visceral, and Endocrine Surgery, Pitié Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France.
Séverine NoulletDepartment of General, Visceral, and Endocrine Surgery, Pitié Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France.
Isabelle BrocheriouDepartment of Pathology, Pitié Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France.
Laurence LeenhardtDepartment of Endocrinology, Thyroid and Endocrine Tumors Unit, Pitié Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France.
Camille BuffetDepartment of Endocrinology, Thyroid and Endocrine Tumors Unit, Pitié Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France.
Fabrice MenegauxDepartment of General, Visceral, and Endocrine Surgery, Pitié Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France.
Assistance Publique – Hôpitaux de Paris · FRPitié-Salpêtrière Hospital · FRSorbonne Université · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInternational guidelines for the management of differentiated thyroid cancers are based on the 7th TNM classification: pT3 tumors are defined as differentiated thyroid cancers (DTCs) measuring more than 4 cm in their greatest dimension that are limited to the thyroid or any tumor with minimal extrathyroidal extension (ETE; sternothyroid muscle or perithyroid soft tissues). Differences in clinicohistological features and prognosis among patients with pT3 tumors remain controversial, and studies regarding pT3 subgroups are lacking.

objectiveTo analyze the prognosis of four subgroups of pT3 DTCs (papillary, PTC; or follicular, FTC). DESIGN AND

settingThe data of patients who underwent surgery for pT3 DTC between 1978 and 2015 in a surgical department specialized in endocrine surgery were reviewed. Patients were classified into four groups as follows: the pT3a (≤ 10 mm with ETE), pT3b (10-40 mm with ETE), pT3c (> 40 mm without ETE), and pT3d groups (> 40 mm with ETE). Recurrence-free survival (RFS) was analyzed using the Kaplan-Meier method.

resultsOne thousand eighty-eight patients with pT3 DTC were included, of whom 311 (29%) had pT3a; 548 (50%), pT3b; 165 (15%), pT3c; and 64 (6%), pT3d. For the 916 patients with lymph node (LN) dissection, metastatic LNs were more frequent in the pT3b and pT3d groups (61 and 61%, respectively) than in the other groups (44% pT3a and 10% pT3c; p < 0.001). During the median follow-up period of 9 years (range, 2-38 years), recurrence occurred in 169 patients with T3 tumors (16%), including 18 with pT3a (6%), 100 with pT3b (18%), 20 with pT3c (12%), and 31 with pT3d (48%). In a multivariate analysis, LN metastases (< 0.0001), extranodal extension (p = 0.03), FTC (vs. PTC) (p = 0.006), pT3b (p = 0.016), and pT3d (p = 0.047) were associated with an increased risk of recurrence. The 5-year RFS rates were 94.5, 82.2, 91.1, and 50.3% for the pT3a, pT3b, pT3c, and pT3d groups, respectively (p < 0.01).

conclusionExcept for microcarcinoma, the risk of LN involvement is high and similar for the DTC patients with minimal ETE, regardless of the size of the tumor. The association of a tumor size of > 4 cm and ETE are associated with a poor prognosis and should justify the classification of these cases as a high-risk group. Other pT3 patients with no LN metastases could be individualized as a low-risk group.

Indexed as

Adenocarcinoma, FollicularAdultAgedAged, 80 and overAnalysis of VarianceCarcinoma, PapillaryCohort StudiesDatabases, FactualDisease-Free SurvivalFemaleHumansKaplan-Meier EstimateLymph Node ExcisionLymph NodesMaleMiddle AgedClinicopathological featuresLymph node dissectionNeoplasm recurrence, localThyroid cancer, well differentiated, papillary, follicularTumor staging

Identifiers

PMID29445865
OpenAlexW2788707639

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.