ArticlePloS one2019
Minimal extrathyroidal extension affects the prognosis of differentiated thyroid cancer: Is there a need for change in the AJCC classification system?
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Integrating the Interaction Between Extrathyroidal Extension and Tumor Size to Optimize T Stage in Differentiated Thyroid Cancer.Balkan medical journal · 2026Article
- Ultrasound feature-based nomogram model for predicting extrathyroidal extension in papillary thyroid carcinoma.BMC cancer · 2025Article
- The Initial Risk Stratification System for Differentiated Thyroid Cancer: Key Updates in the 2024 Korean Thyroid Association Guideline.Endocrinology and metabolism (Seoul, Korea) · 2025Review
- Clinical Significance of Gross Extrathyroidal Extension to Only the Strap Muscle According to Tumor Size in Differentiated Thyroid Cancer: A Systematic Review and Meta-Analysis.Clinical and experimental otorhinolaryngology · 2024Article
- The Role of Risk Factors for the Progression of Patients with T1b-T2 Papillary Thyroid Carcinoma (PC) during Long-Term Follow-Up.Journal of clinical medicine · 2024Article
- The superior value of radiomics to sonographic assessment for ultrasound-based evaluation of extrathyroidal extension in papillary thyroid carcinoma: a retrospective study.Radiology and oncology · 2024Article
- Article
- Rethinking the prognosis model of differentiated thyroid carcinoma.Frontiers in endocrinology · 2024Article
- Potential impact of obesity on the aggressiveness of low- to intermediate-risk papillary thyroid carcinoma: results from a MASTER cohort study.Endocrine · 2023Article
- Impact of microscopic extrathyroidal extension on differentiated thyroid cancer post-surgical risk of recurrence: a retrospective analysis.Journal of endocrinological investigation · 2023Article
- Diagnostic Accuracy of Ultrasound in Predicting Extrathyroidal Extension and Its Relation to Body Mass Index in a North American Population.Biomedicines · 2022Article
- A critical analysis of the current TNM classification for differentiated thyroid carcinoma in young patients: Time for a change?Frontiers in endocrinology · 2022Article
- The Diagnostic Usefulness ofDiagnostics (Basel, Switzerland) · 2021Article
- Long-term disease recurrence in the adipose tissue and striated muscles of a minimally invasive papillary thyroid carcinoma.Endocrine · 2021Article
- The influence of nodule size on the aggressiveness of thyroid carcinoma varies with patient's age.Gland surgery · 2021Article
- Microscopic Extrathyroidal Extension Results in Increased Rate of Tumor Recurrence and Is an Independent Predictor of Patient's Outcome in Middle Eastern Papillary Thyroid Carcinoma.Frontiers in oncology · 2021Article
- Referral Practice for Radioactive Iodine Ablation (RAI) after ATA guidelines 2015: results from a Tertiary Cancer Care Centre.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2020Article
- Machine Learning and Feature Selection Applied to SEER Data to Reliably Assess Thyroid Cancer Prognosis.Scientific reports · 2020Article
- Prognostic significance of minimal extrathyroidal extension in differentiated thyroid carcinoma: a retrospective cohort study.Brazilian journal of otorhinolaryngologyArticle
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Abstract
Minimal extrathyroidal extension (ETE) is defined as tumor cells extending to the sternothyroid muscle or perithyroidal soft tissue. However, there is controversy regarding whether the magnitude of ETE (minimal or gross) should be considered in assigning a precise TNM stage to patients with thyroid cancer in the seventh/eighth editions of the AJCC system. The present study evaluated Surveillance, Epidemiology, and End Results data from 107,114 patients with differentiated thyroid cancer (2004-2013) to determine whether the magnitude of ETE (thyroid confinement, minimal, or gross) influenced the ability to predict cancer-specific survival (CSS) and overall survival (OS). Patient mortality was evaluated using Cox proportional hazards regression analyses and Kaplan-Meier analyses with log-rank tests. The cancer-specific mortality rates per 1,000 person-years were 1.407 for the thyroid confinement group (95% CI: 1.288-1.536), 5.133 for the minimal ETE group (95% CI: 4.301-6.124), and 29.735 for the gross ETE group (95% CI: 28.147-31.412). Relative to the thyroid confinement group, patients with minimal ETE and gross ETE had significantly poorer CSS and OS in the univariate and multivariate analyses (both P<0.001). After propensity-score matching according to age, sex, and race, we found that thyroid confinement was associated with better CSS and OS rates than minimal ETE (P<0.001) and gross ETE (P<0.001). These results from a population-based cohort provide a reference for precise personalized treatment and management of patients with minimal ETE. Furthermore, it may be prudent to revisit the magnitude of ETE as advocated by the AJCC and currently used for treatment recommendation by the American Thyroid Association.
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