Prognostic Factors Improving American Thyroid Association (ATA) Risk System and Dynamic Risk Stratification in Low- and Intermediate-Risk Differentiated Thyroid Carcinoma (DTC) Patients
Main finding · Outcome in intermediate-risk patientsResult — go to the resultOdds ratio 3.9 95% CI 1.9–8.6Authors' conclusion
Our results suggest that age at diagnosis further predict individual outcomes in Intermediate-Risk DTC allowing ongoing management to be tailored accordingly.
Study context
- Population
- DTC patients classified at low (449/863) or intermediate (414/863) risk by the ATA stratification system; mean follow-up 10 ± 6.2 years
- Participants
- 863 patients
- Exposure
- Age at diagnosis ≥55 vs <55 years within ATA low- and intermediate-risk classes
- Outcome
- Short- and long-term outcome (persistent/recurrent disease) by age at diagnosis
Main finding
Outcome in intermediate-risk patients
Odds ratio
3.9
95% CI 1.9–8.6
P < 0.001
By group
≥55 years
- Structural disease
- 11.6%
- Recurrent disease
- 4.1%
- Death
- 4.1%
<55 years
- Structural disease
- 8.9%
- Recurrent disease
- 0.7%
- Death
- 1%
Structural disease
≥55 years11.6%
<55 years8.9%
Recurrent disease
≥55 years4.1%
<55 years0.7%
Death
≥55 years4.1%
<55 years1%
≥55 yearsvs <55 years
OR 3.9 (95% CI 1.9–8.6); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
Other independent risk factors for worse long-term outcome (multivariate)
- Response to initial therapy, OR
- 13.0 (95% CI 6.3-27.9; P < .001)
- T category, OR
- 32 (95% CI 1.4-7.1; P = .005)
- N category, OR
- 2.3 (95% CI 1.1-5.0; P = .03)
Worse long-term outcome in intermediate-risk subgroups
- Whole intermediate-risk population
- 13.3%
- Persistent structural disease after initial therapy (P < .001)
- 47.8%
- Age >55 years and persistent structural disease after initial therapy (P = .02)
- 80%
- Negative effect of older age documented only in intermediate-risk patients with persistent structural disease after initial therapy
Original publication
Prognostic Factors Improving ATA Risk System and Dynamic Risk Stratification in Low- and Intermediate-Risk DTC Patients. J Clin Endocrinol Metab. Published 7 October 2023. doi:10.
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