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Patients aged 55 years and older with extranodal extension (ENE), metastatic lymph node ratio (LNR), and no initial treatment are at increased risk of recurrence of papillary thyroid carcinoma (PTC), according to a retrospective study published in is said to be high. Frontiers of endocrinology.1
Identifying these risks is considered a “practical and useful tool” that allows physicians to predict the likelihood of PTC recurrence.
A total of 955 PTC patients were evaluated from 2017 to 2020. To be eligible, the patient must have had her PTC with the following symptoms: BRAF V600 or the telomerase reverse transcriptase promoter (TERTp)mutation. PTC recurrence rate was 3.98% (n = 38).
The recurrence rate was higher in patients aged 55 years and older, with 31.58% of recurrence-positive patients aged 55 years and older and 11.89% of recurrence-negative patients aged 55 years and older (P =.001). Patients in the recurrence-positive group had higher rates of: TERTp Mutation (13.16% vs 2.29%; P <.001). They were also significantly more likely to have not received initial treatment (55.26% vs. 9.92%; P <.001).
Previous studies have identified ENE and LNR to be associated with poor disease prognosis. Regarding ENE, 28.95% of recurrence-positive patients had his ENE, whereas in recurrence-negative patients he had 6.98% (P <.001)。 LNR については、再発陽性患者の 34.21% が LNR >0.5 compared to 13.20% in patients with negative recurrence (P <.001).
“The proposed prediction model has shown the ability to accurately predict based on existing patient characteristics, thereby going beyond the limitations of traditional studies. highlighted the risk of recurrence in patients who have not received initial treatment, which may be due to social and socio-environmental factors. Therefore, clinicians should remain optimistic about the good prognosis of PTC in non-primitive cases. “Re-evaluation is necessary, and a more aggressive and cautious approach to the diagnosis and management of such patients is needed,” the study authors wrote.
No significant differences were observed in gender, mean age, vascular invasion, number of metastatic lymph nodes, or recurrence status. BRAF V600 mutations, or aggressive subtypes.
Interestingly, Hashimoto’s thyroiditis (HT) is associated with an increased risk of cancer, particularly thyroid cancer.2 It appears to be able to prevent recurrence of PTC to some extent. Only 7.89% of patients in the recurrence-positive group suffered from HT, compared to 23.83% in the recurrence-negative group (P =.037).1
“Previous research results show that HT and [nodular goiter] It may limit tumor progression through specific mechanisms and improve patient outcomes. The high proportion of tumor-infiltrating lymphocytes may explain the protective role of HT. However, similar effects of NG remain uncertain,” the study authors wrote.1
