PMID- 32953600
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220417
IS  - 2227-684X (Print)
IS  - 2227-8575 (Electronic)
IS  - 2227-684X (Linking)
VI  - 9
IP  - 4
DP  - 2020 Aug
TI  - Synergic effects of histology subtype, lymph node metastasis, and distant 
      metastasis on prognosis in differentiated thyroid carcinoma using the SEER 
      database.
PG  - 907-918
LID - 10.21037/gs-20-273 [doi]
AB  - BACKGROUND: Differentiated thyroid carcinoma (DTC) is the most common clinical 
      type of thyroid carcinoma. There are rare reports on the synergic effects of the 
      different clinicopathological risk factors on the prognosis of it. METHODS: We 
      retrospectively reviewed data on 86,032 DTC patients from the Surveillance, 
      Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox 
      regression analyses were conducted to evaluate the correlation between 
      clinicopathological factors and the prognosis of DTC. Relative excess risk (RERI) 
      of synergic effect, attributable proportion (AP) of synergic effect, and synergy 
      index (SI) were calculated to assess synergic effects. Kaplan-Meier analyses with 
      log-rank tests was used to plot the survival curve affected by different risk 
      factors. RESULTS: Histology subtype, lymph node metastasis (LNM) status, and 
      distant metastasis (DM) were independent risk factors for cancer-specific 
      survival (CSS) and all-cause survival (ACS) in the multivariate analysis (all, 
      P<0.001). Patients' age at diagnosis, sex, extrathyroidal extension, and 
      radiation also influenced prognosis (all, P<0.001). The cancer-specific mortality 
      (CSM) and all-cause mortality (ACM) rates per 1,000 person-years were higher in 
      patients with follicular thyroid carcinoma (FTC) and in those with N1 stage and 
      M1 stage disease. Furthermore, we observed a significant synergic effect between 
      histology subtype and N stage, as well as histology subtype and M stage for the 
      CSM of DTC (RERI =48.806, AP =0.853, SI =7.565; RERI =37.889, AP =0.430, SI 
      =1.771, respectively). However, no synergic effect was observed in the case of 
      the N stage and M stage for the CSM of DTC (RERI =7.928, AP =0.084, SI =1.093). 
      CONCLUSIONS: Patients with histology subtype of FTC and N1 stage, histology 
      subtype of FTC and M1 stage had significant additive synergic effects on DTC 
      prognosis for CSM.
CI  - 2020 Gland Surgery. All rights reserved.
FAU - Zhou, Ling
AU  - Zhou L
AD  - Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 
      China.
FAU - Li, Qianqian
AU  - Li Q
AD  - Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 
      China.
FAU - Chen, Sichao
AU  - Chen S
AD  - Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 
      China.
FAU - Huang, Yihui
AU  - Huang Y
AD  - Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 
      China.
FAU - Wei, Wei
AU  - Wei W
AD  - Department of Pediatrics, St. John Hospital and Medical Center, Detroit, MI, USA.
FAU - Zhang, Chao
AU  - Zhang C
AD  - Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, 
      Huazhong University of Science and Technology, Wuhan, China.
FAU - Wang, Min
AU  - Wang M
AD  - Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 
      China.
FAU - Zhou, Wei
AU  - Zhou W
AD  - Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 
      China.
FAU - Zeng, Wen
AU  - Zeng W
AD  - Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, China.
FAU - Liu, Zeming
AU  - Liu Z
AD  - Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 
      China.
FAU - Guo, Liang
AU  - Guo L
AD  - Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 
      China.
LA  - eng
PT  - Journal Article
PL  - China (Republic : 1949- )
TA  - Gland Surg
JT  - Gland surgery
JID - 101606638
PMC - PMC7475367
OTO - NOTNLM
OT  - Differentiated thyroid carcinoma (DTC)
OT  - Surveillance, Epidemiology, and End Results (SEER)
OT  - prognosis
OT  - synergic effect
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at http://dx.doi.org/10.21037/gs-20-273). The authors have no 
      conflicts of interest to declare.
EDAT- 2020/09/22 06:00
MHDA- 2020/09/22 06:01
PMCR- 2020/08/01
CRDT- 2020/09/21 06:16
PHST- 2020/09/21 06:16 [entrez]
PHST- 2020/09/22 06:00 [pubmed]
PHST- 2020/09/22 06:01 [medline]
PHST- 2020/08/01 00:00 [pmc-release]
AID - gs-09-04-907 [pii]
AID - 10.21037/gs-20-273 [doi]
PST - ppublish
SO  - Gland Surg. 2020 Aug;9(4):907-918. doi: 10.21037/gs-20-273.