Revisiting the Relationship Between Tumor Size and Risk in Well-Differentiated Thyroid Cancer
Main finding · Death (survival) by tumor size >4 cm vs ≤4 cm, propensity-matchedResult — go to the resultHR of death 1.63Authors' conclusion
Concomitant high-risk features confer worse survival than large tumor size alone, and a 4 cm cutoff is not associated with the greatest increase in risk.
Study context
- Population
- Patients with well-differentiated thyroid cancer, National Cancer Database (2010–2015); 7.9% had tumors >4 cm, 30% ≥1 high-risk featureprimary cohort
- Participants
- 193,133 patients
- Exposure
- Tumor size >4 cm vs ≤4 cm
- Outcome
- Survival
Methodological detailspropensity score matched, National Cancer Database, validation cohort from SEER
- Propensity score matched
- National Cancer Database
- Validation cohort from SEER
Main finding
As reported in the abstract
Death (survival) by tumor size >4 cm vs ≤4 cm, propensity-matched
HR of death
1.63
P < 0.001
Observational data: associations, not effects.
Further findings
Survival: size >4 cm plus ≥1 other high-risk feature vs size >4 cm alone or high-risk features alone
- Worse survival with combination vs size >4 cm alone (MMD)
- 0.70, p < 0.001
- Worse survival with combination vs other high-risk features alone (MMD)
- 0.49, p < 0.001
Hazard of death by 1 cm increments in tumor size
- Largest increases in hazard of death at 2 cm and 5 cm, not 4 cm
Validation cohort (SEER 2008-2013)
- Results largely consistent with primary findings
Original publication
Revisiting the Relationship Between Tumor Size and Risk in Well-Differentiated Thyroid Cancer. Thyroid. Published 24 July 2024. doi:10.
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