Can Age at Diagnosis and Sex Improve the Performance of the American Thyroid Association Risk Stratification System for Prediction of Structural Persistent and Recurrent Disease in Patients With Differentiated Thyroid Carcinoma? A Multicenter Study

dc.authorscopusid36656843500
dc.authorscopusid57222618071
dc.authorscopusid56735615100
dc.authorscopusid57215874186
dc.authorscopusid57147304700
dc.authorscopusid55356053700
dc.authorscopusid35572617400
dc.contributor.authorZuhur, Sayid Shafi
dc.contributor.authorAğgül, Hünkar
dc.contributor.authorÇelik, M.
dc.contributor.authorAvcı, U.
dc.contributor.authorErol, Selvinaz
dc.contributor.authorKılınç, F.
dc.contributor.authorAltuntaş, Yüksel
dc.contributor.authorBilen, O.
dc.contributor.authorElbuken, G.
dc.contributor.authorTopçu, B.
dc.date.accessioned2022-05-11T14:02:51Z
dc.date.available2022-05-11T14:02:51Z
dc.date.issued2022
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.departmentFakülteler, Tıp Fakültesi, Temel Tıp Bilimleri Bölümü, Biyoistatistik Ana Bilim Dalı
dc.description.abstractObjective: Although the age at diagnosis has been suggested as a major determinant of disease-specific survival in the recent TNM staging system, it is not included in the recent American Thyroid Association (ATA) guidelines to estimate the risk of recurrence. Nevertheless, the effect of sex on differentiated thyroid carcinoma (DTC) recurrence is controversial. Therefore, this multicenter study was conducted to assess whether age at diagnosis and sex can improve the performance of the ATA 3-tiered risk stratification system in patients with DTC with at least 5 years of follow-up. Methods: In this study, the computer-recorded data of the patients diagnosed with DTC between January 1985 and January 2016 were analyzed. Only patients with proven structural persistent/recurrent disease were selected for comparisons. Results: This study consisted of 1691 patients (female, 1367) with DTC. In Kaplan-Meier analysis, disease-free survival (DFS) was markedly longer in females only in the ATA low-risk category (P = .045). Nevertheless, a markedly longer DFS was observed in patients aged <45 years in the ATA low- and intermediate-risk categories (P = .004 and P = .009, respectively), whereas in patients aged <55 years, DFS was markedly longer only in the ATA low-risk category (P < .001). In the Cox proportional hazards model, ages of ?45 and ?55 years at diagnosis and the ATA risk stratification system were all independent predictors of persistent/recurrent disease. Conclusion: Applying the age cutoff of 45 years in the ATA intermediate- and low-risk categories may identify patients at a higher risk of persistence/recurrence and may improve the performance of the ATA risk stratification system, whereas sex may improve the performance of only the ATA low-risk category. © 2021 AACE
dc.description.sponsorshipWe would like to thank all surgeons who performed the surgical interventions and the pathologists who examined the pathology specimens of the patients included in this study. The authors have no multiplicity of interest to disclose.
dc.identifier.doi10.1016/j.eprac.2021.09.001
dc.identifier.endpage35
dc.identifier.issn1530-891X
dc.identifier.issue1en_US
dc.identifier.pmid34508902
dc.identifier.scopus2-s2.0-85116843233
dc.identifier.scopusqualityQ1
dc.identifier.startpage30
dc.identifier.urihttps://doi.org/10.1016/j.eprac.2021.09.001
dc.identifier.urihttps://hdl.handle.net/20.500.11776/4515
dc.identifier.volume28
dc.identifier.wosWOS:000741473100006
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorZuhur, Sayid Shafi
dc.institutionauthorAğgül, Hünkar
dc.institutionauthorBilen, O.
dc.institutionauthorElbuken, G.
dc.institutionauthorTopçu, B.
dc.language.isoen
dc.publisherElsevier B.V.
dc.relation.ispartofEndocrine Practice
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectage
dc.subjectATA risk stratification system
dc.subjectdifferentiated thyroid cancer
dc.subjectrecurrence
dc.subjectsex
dc.subjectadult
dc.subjectArticle
dc.subjectcancer recurrence
dc.subjectcancer staging
dc.subjectcancer survival
dc.subjectdifferentiated thyroid cancer
dc.subjectdisease free survival
dc.subjectfemale
dc.subjectfollow up
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmiddle aged
dc.subjectrecurrent disease
dc.subjectretrospective study
dc.subjectrisk assessment
dc.subjectsex difference
dc.subjectthyroidectomy
dc.subjectclinical trial
dc.subjectmulticenter study
dc.subjectrisk assessment
dc.subjectthyroid tumor
dc.subjectthyroidectomy
dc.subjecttumor recurrence
dc.subjectUnited States
dc.subjectFemale
dc.subjectHumans
dc.subjectMiddle Aged
dc.subjectNeoplasm Recurrence, Local
dc.subjectRetrospective Studies
dc.subjectRisk Assessment
dc.subjectThyroid Neoplasms
dc.subjectThyroidectomy
dc.subjectUnited States
dc.titleCan Age at Diagnosis and Sex Improve the Performance of the American Thyroid Association Risk Stratification System for Prediction of Structural Persistent and Recurrent Disease in Patients With Differentiated Thyroid Carcinoma? A Multicenter Study
dc.typeArticle

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