Molecular Testing Predicts Incomplete Response to Initial Therapy in Differentiated Thyroid Carcinoma Without Lateral Neck or Distant Metastasis at Presentation: Retrospective Cohort Study
Authors' conclusion
Disease recurrence was observed across all ATA RSS categories in short-term follow-up, and tumor size was the only conventional preoperative factor associated with recurrence. When MT results were incorporated, they not only improved predictive ability beyond tumor size alone, but also yielded similar ability as the gold standard ATA RSS.
Study context
- Population
- Thyroid cancer patients without preoperative lateral neck disease or distant metastasis, eligible for lobectomy or total thyroidectomy, index thyroidectomy Nov 1, 2017–Oct 31, 2021440 with molecular testing (MT) results
- Participants
- 945 patients
- Exposure
- Preoperative factors including molecular testing (MT) vs ATA Risk Stratification System (RSS) for predicting recurrence
- Outcome
- Disease recurrence (structural or biochemical); incomplete response to initial therapy
- Follow-up
- 18-month median
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Recurrence by ATA RSS category
P < 0.001
- Overall recurrence
- 50 (5.2%)
Observational data: associations, not effects.
Further findings
Multivariable predictors of recurrence (preoperative factors)
- Only tumor size associated with recurrence, OR
- 1.3 (1.1-1.5) (95% CI)
Model with MT results (440 patients)
- Larger tumor size, OR
- 1.4 (1.1-1.8) (95% CI)
- MT results associated with recurrence
- P < 0.001
- Including MT improved the c-statistic by
- 27%
- MT model vs RSS-only model, c-statistic: no statistical difference
- P = 0.15
Original publication
Molecular Testing Predicts Incomplete Response to Initial Therapy in Differentiated Thyroid Carcinoma Without Lateral Neck or Distant Metastasis at Presentation: Retrospective Cohort Study. Thyroid. Published 28 April 2023. doi:10.
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