Data-driven thresholds for tumor size and nodal involvement in oncocytic thyroid carcinoma: A population-based analysis.

INTRODUCTION: We sought to identify prognostically meaningful thresholds for tumor size and lymph node (LN) metastasis as a first step toward developing a dedicated staging system for oncocytic thyroid carcinoma (OTC). METHODS: Using SEER (2004-2022), tumor size and LN thresholds for OTC were analyzed using restricted cubic splines; Cox models estimated association with overall (OS) and disease-specific survival (DSS). RESULTS: Among 4114 patients, median tumor size was 34 mm, and 1410 (34.3%) had ≥1 LN examined. Tumor size showed a linear relationship with OS and DSS (no prognostic threshold). LN positivity showed thresholds of 2.42 positive LNs for OS and 2.14 for DSS; thus, ≥3 positive LNs was considered a prognostic threshold. Patients with ≥3 vs < 3 positive LNs had lower adjusted DSS (HR 3.32; p < 0.001) and OS (HR 2.65; p < 0.001). CONCLUSION: For OTC, ≥3 positive LNs constituted a prognostic threshold, while tumor size conferred continuous risk.

Duke Scholars

Author Samantha Thomas  

Author Todd William Frieze Medicine, Endocrinology, Metabolism, and Nutrition

Author Randall Paul Scheri Surgical Oncology

Author Hadiza Shu'aib Kazaure Surgical Oncology