Disease-Specific Survival Trends for Patients Presenting with Differentiated Thyroid Cancer and Distant Metastases in the United States, 1992–2018
Authors' conclusion
Patients diagnosed with distant metastatic DTC have experienced no improvement in DSS over the past three decades. An increasing proportion of patients diagnosed with distant metastatic DTC are receiving nonsurgical treatment or no/unknown treatment over time; the proportion was highest among the oldest patients.
Study context
- Population
- Patients with distant metastatic differentiated thyroid cancer (DTC), SEER-13, 1992–2018; 69.7% white, 58.0% female, 47.5% aged ≥65 years; PTC 74.5%
- Participants
- 1,991 patients
- Exposure
- Diagnosis periods 1992-1998 vs 1999-2008 vs 2009-2018
- Outcome
- 10-year disease-specific survival (DSS) trends
- Follow-up
- 10 years
Methodological detailsSEER-13 cancer registry, multivariable logistic and Cox regression, log-linear regression for annual percentage changes
- SEER-13 cancer registry
- Multivariable logistic and Cox regression
- Log-linear regression for annual percentage changes
Main finding
As reported in the abstract
P = 0.48
Observational data: associations, not effects.
Further findings
10-year DSS, overall DTC · 10 years — between 1992-1998 and 2009-2018 · increased over time; across the three periods
P < 0.01
| Outcome | 1992-1998 | 1999-2008 | 2009-2018 | P value |
|---|---|---|---|---|
| Rate of nonsurgical treatment2009-2018 vs 1992-1998 | 22.9% | — not stated in the abstract | 25.6% | P = 0.03 |
| Rate of no/unknown treatment2009-2018 vs 1992-1998 | 11.3% | — not stated in the abstract | 15.6% | P = 0.01 |
— not stated in the abstract
Per year
- Rate of nonsurgical treatment — Average annual increase
- 1.3%
- Rate of no/unknown treatment — Annual increase
- 1.9%
10-year disease-specific survival (DSS) in subgroups (distant metastatic DTC)
- Aged ≥65 years
- 28.1%
- Nonsurgical treatment (external beam radiation and/or systemic therapy)
- 6.0%
- No/unknown treatment
- 32.8%
Factors associated with increased risk of thyroid cancer death (multivariable)
- Oncocytic carcinoma, age 65-79 and ≥80 years, male sex, node-positive disease, larger tumor size, nonsurgical treatment, and no/unknown treatment
Management by age
- Patients aged 65-79 and ≥80 years more likely than younger patients to receive nonsurgical management or no/unknown treatment
Original publication
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