ArticleAnnals of translational medicine2019
Synergic effects of histology subtype, tumor size, and lymph node metastasis on distant metastasis in differentiated thyroid cancer.
Article in Annals of translational medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Clinical, Pathological, and Molecular Characteristics Correlating to the Occurrence of Radioiodine Refractory Differentiated Thyroid Carcinoma: A Systematic Review and Meta-Analysis.Frontiers in oncology · 2020Pooled it
- Epidemiology, risk factor and prognostic factor of young differentiated thyroid carcinoma with distant metastasis: a retrospective cohort study.American journal of cancer research · 2026Article
- Short-term impact of delayed surgical treatment on the prognosis of patients with T1bN1-stage PTC: a retrospective cohort study.BMC cancer · 2025Article
- Challenging diagnosis and treatment of rare paranasal sinus metastasis from thyroid cancer: a case report and literature review.Frontiers in endocrinology · 2025Review
- Sex disparities in thyroid cancer may need further exploration.Gland surgery · 2023Article
- Nomogram individually predicts the risk for distant metastasis and prognosis value in female differentiated thyroid cancer patients: A SEER-based study.Frontiers in oncology · 2022Article
- Can Cervical Lymph Node Metastasis Increase the Risk of Distant Metastasis in Papillary Thyroid Carcinoma?Frontiers in endocrinology · 2022Article
- Bone metastases in newly diagnosed patients with thyroid cancer: A large population-based cohort study.Frontiers in oncology · 2022Article
- Identification and validation of potential novel biomarkers to predict distant metastasis in differentiated thyroid cancer.Annals of translational medicine · 2021Article
- Novel nomogram to predict risk of bone metastasis in newly diagnosed thyroid carcinoma: a population-based study.BMC cancer · 2020Article
- Predictive factors of lateral lymph node metastasis in conventional papillary thyroid carcinoma.Gland surgery · 2020Article
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Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDetection of distant metastasis (DM) is important in differentiated thyroid cancer (DTC). This study aimed to investigate the synergic effects of histology subtype, tumor size, and lymph node metastasis (LNM) status on the occurrence of DM in DTC.
methodsWe collected data of 96,788 patients with DTC. Univariate and multivariate analyses were conducted to identify the risk factors of DM. Relative excess risk of synergic effect, attributable proportion of synergic effect, and synergy index were then calculated to assess synergic effects. Further, Kaplan-Meier method using the log-rank test and receiver operating characteristic (ROC) curves were utilized.
resultsAge at diagnosis (P<0.001), sex (P<0.001), race (P<0.01), tumor size (P<0.001), N stage (P < 0.001), histology subtype (P<0.001), and extrathyroidal extension (P<0.001) were risk factors for DM in both univariate and multivariate analyses. We also found a significant additive synergic effect between histology subtype and LNM, and between tumor size and LNM on DM in the DTC patients. In addition, patients with follicular thyroid cancer and N1 stage had the sharpest decline in cancer-specific survival curves (P<0.001) and all-cause survival curves (P<0.001) compared to patients with other combinations of histology subtype and N stage. Similar results were obtained in patients with larger tumors (≥10 mm) and N1 stage. The areas under the curve of histology subtype, tumor size, and LNM status were 0.569, 0.744, and 0.681, respectively.
conclusionsAge at diagnosis, sex, race, tumor size, N stage, histology subtype, and extrathyroidal extension are risk factors for DM in DTC patients. LNM has a synergic effect with either follicular thyroid histology or larger tumor size for higher risk of DM which is important for diagnosing DM.
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