Extrathyroidal Extension: Does Strap Muscle Invasion Alone Influence Recurrence and Survival in Patients with Differentiated Thyroid Cancer?

Annals of Surgical Oncology
Moran AmitMark Zafereo

Abstract

According to the 8th edition American Joint Committee on Cancer staging system, extrathyroidal extension (ETE) and primary tumor size remain the principle determinants of T stage. However, impact of gross ETE into strap muscles on survival remains controversial. A retrospective review of 2084 patients with ≤ 4 cm nonmetastatic differentiated thyroid cancer who underwent surgery between 2000 and 2015 was conducted. Patients were divided into three groups according to degree of ETE: no ETE (group 1), ETE into perithyroidal soft tissue (group 2), and gross ETE into strap muscle (group 3). Survivals were analyzed using Kaplan-Meier method and compared using log-rank test. Factors predictive of survival were analyzed using Cox proportional hazard model. Ten-year disease-free survival (DFS) of patients in groups 1-3 was 90, 82, and 83%, respectively (p = 0.003). On multivariate analysis, age ≥ 55 years, male sex, and pathologic N1b category predicted significantly worse DFS, while ETE into perithyroidal soft tissue or gross strap muscle invasion did not predict worse DFS. Overall survival (p = 0.957) and disease-specific survival (p =0.910) were not significantly different between the three groups. There was a statistically significa...Continue Reading

References

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Citations

Dec 14, 2019·Thyroid : Official Journal of the American Thyroid Association·Genpeng LiJingqiang Zhu
Aug 4, 2020·Clinical Endocrinology·Jingzhe XiangHao Zhang
Feb 16, 2020·Thyroid : Official Journal of the American Thyroid Association·Debora L S DanilovicSuemi Marui
Aug 8, 2020·Head & Neck·Ohad RonenAlfio Ferlito
Jan 19, 2020·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·I J NixonA Ferlito
Oct 23, 2020·European Thyroid Journal·Chi-Yu KuoShih-Ping Cheng

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