Number of tumor foci predicts prognosis in papillary thyroid cancer

Ning Qu, Ling Zhang, Qing Hai Ji, Yong Xue Zhu, Zhuo Ying Wang, Qiang Shen, Yu Wang, Duan Shu Li

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Papillary thyroid cancer (PTC) often presents as multifocal. However, the association of multifocality with poor prognosis remains controversial. The aim of this retrospective study was to identify the characteristics of PTC with multiple foci and to evaluate the association between multifocality and prognosis. Methods: We reviewed the medical records of 496 patients who underwent total thyroidectomy for PTC. Patients were classified as G1 (1 tumor focus), G2 (2 foci), and G3 (3 or more foci). We analyzed the clinicopathological features and clinical outcomes in each classification. A Cox regression model was used to assess the relationship between multifocality and recurrence or cancer mortality. Results: The G1, G2 and G3 groups included 287, 141 and 68 patients, respectively. The mean age was 47.1±16.1 yr in G1, 41.1±18.4 yr in G2, and 35.5±15.9 yr in G3 and differed significantly among the 3 groups (p=0.001). The proportion of extrathyroidal extension, central lymph node metastasis (CLNM), and lateral lymph node metastasis (LLNM) in the G1 to G3 groups increased with increasing number of tumor foci. The Kaplan-Meier curves revealed that G3 had the shortest recurrence-free survival, and differences were significant among the 3 groups (p=0.001, Log Rank test). Furthermore, cancer-specific survival rates decreased significantly with increasing number of tumor foci (p=0.041). Independent predictors of recurrence by multivariate Cox analysis included >3 tumor foci [HR 2.60, 95% confidence interval (CI) 1.53-4.39, p=0.001] and extrathyroidal extension (HR 1.95, CI 1.12-3.38, p=0.018). Conclusion: An increase in the number of tumors is associated with a tendency toward more aggressive features and predicts poor prognosis in PTC.

Original languageEnglish (US)
Article number914
JournalBMC cancer
Volume14
Issue number1
DOIs
StatePublished - Dec 4 2014

Fingerprint

Neoplasms
Recurrence
Lymph Nodes
Confidence Intervals
Neoplasm Metastasis
Thyroidectomy
Papillary Thyroid cancer
Proportional Hazards Models
Medical Records
Multivariate Analysis
Survival Rate
Retrospective Studies
Survival
Mortality

Keywords

  • Mortality
  • Multifocality
  • Papillary thyroid carcinoma
  • Recurrence

ASJC Scopus subject areas

  • Genetics
  • Oncology
  • Cancer Research

Cite this

Qu, N., Zhang, L., Ji, Q. H., Zhu, Y. X., Wang, Z. Y., Shen, Q., ... Li, D. S. (2014). Number of tumor foci predicts prognosis in papillary thyroid cancer. BMC cancer, 14(1), [914]. https://doi.org/10.1186/1471-2407-14-914

Number of tumor foci predicts prognosis in papillary thyroid cancer. / Qu, Ning; Zhang, Ling; Ji, Qing Hai; Zhu, Yong Xue; Wang, Zhuo Ying; Shen, Qiang; Wang, Yu; Li, Duan Shu.

In: BMC cancer, Vol. 14, No. 1, 914, 04.12.2014.

Research output: Contribution to journalArticle

Qu, N, Zhang, L, Ji, QH, Zhu, YX, Wang, ZY, Shen, Q, Wang, Y & Li, DS 2014, 'Number of tumor foci predicts prognosis in papillary thyroid cancer', BMC cancer, vol. 14, no. 1, 914. https://doi.org/10.1186/1471-2407-14-914
Qu, Ning ; Zhang, Ling ; Ji, Qing Hai ; Zhu, Yong Xue ; Wang, Zhuo Ying ; Shen, Qiang ; Wang, Yu ; Li, Duan Shu. / Number of tumor foci predicts prognosis in papillary thyroid cancer. In: BMC cancer. 2014 ; Vol. 14, No. 1.
@article{2bb6211e9e434441979a49bfa12f1139,
title = "Number of tumor foci predicts prognosis in papillary thyroid cancer",
abstract = "Background: Papillary thyroid cancer (PTC) often presents as multifocal. However, the association of multifocality with poor prognosis remains controversial. The aim of this retrospective study was to identify the characteristics of PTC with multiple foci and to evaluate the association between multifocality and prognosis. Methods: We reviewed the medical records of 496 patients who underwent total thyroidectomy for PTC. Patients were classified as G1 (1 tumor focus), G2 (2 foci), and G3 (3 or more foci). We analyzed the clinicopathological features and clinical outcomes in each classification. A Cox regression model was used to assess the relationship between multifocality and recurrence or cancer mortality. Results: The G1, G2 and G3 groups included 287, 141 and 68 patients, respectively. The mean age was 47.1±16.1 yr in G1, 41.1±18.4 yr in G2, and 35.5±15.9 yr in G3 and differed significantly among the 3 groups (p=0.001). The proportion of extrathyroidal extension, central lymph node metastasis (CLNM), and lateral lymph node metastasis (LLNM) in the G1 to G3 groups increased with increasing number of tumor foci. The Kaplan-Meier curves revealed that G3 had the shortest recurrence-free survival, and differences were significant among the 3 groups (p=0.001, Log Rank test). Furthermore, cancer-specific survival rates decreased significantly with increasing number of tumor foci (p=0.041). Independent predictors of recurrence by multivariate Cox analysis included >3 tumor foci [HR 2.60, 95{\%} confidence interval (CI) 1.53-4.39, p=0.001] and extrathyroidal extension (HR 1.95, CI 1.12-3.38, p=0.018). Conclusion: An increase in the number of tumors is associated with a tendency toward more aggressive features and predicts poor prognosis in PTC.",
keywords = "Mortality, Multifocality, Papillary thyroid carcinoma, Recurrence",
author = "Ning Qu and Ling Zhang and Ji, {Qing Hai} and Zhu, {Yong Xue} and Wang, {Zhuo Ying} and Qiang Shen and Yu Wang and Li, {Duan Shu}",
year = "2014",
month = "12",
day = "4",
doi = "10.1186/1471-2407-14-914",
language = "English (US)",
volume = "14",
journal = "BMC Cancer",
issn = "1471-2407",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Number of tumor foci predicts prognosis in papillary thyroid cancer

AU - Qu, Ning

AU - Zhang, Ling

AU - Ji, Qing Hai

AU - Zhu, Yong Xue

AU - Wang, Zhuo Ying

AU - Shen, Qiang

AU - Wang, Yu

AU - Li, Duan Shu

PY - 2014/12/4

Y1 - 2014/12/4

N2 - Background: Papillary thyroid cancer (PTC) often presents as multifocal. However, the association of multifocality with poor prognosis remains controversial. The aim of this retrospective study was to identify the characteristics of PTC with multiple foci and to evaluate the association between multifocality and prognosis. Methods: We reviewed the medical records of 496 patients who underwent total thyroidectomy for PTC. Patients were classified as G1 (1 tumor focus), G2 (2 foci), and G3 (3 or more foci). We analyzed the clinicopathological features and clinical outcomes in each classification. A Cox regression model was used to assess the relationship between multifocality and recurrence or cancer mortality. Results: The G1, G2 and G3 groups included 287, 141 and 68 patients, respectively. The mean age was 47.1±16.1 yr in G1, 41.1±18.4 yr in G2, and 35.5±15.9 yr in G3 and differed significantly among the 3 groups (p=0.001). The proportion of extrathyroidal extension, central lymph node metastasis (CLNM), and lateral lymph node metastasis (LLNM) in the G1 to G3 groups increased with increasing number of tumor foci. The Kaplan-Meier curves revealed that G3 had the shortest recurrence-free survival, and differences were significant among the 3 groups (p=0.001, Log Rank test). Furthermore, cancer-specific survival rates decreased significantly with increasing number of tumor foci (p=0.041). Independent predictors of recurrence by multivariate Cox analysis included >3 tumor foci [HR 2.60, 95% confidence interval (CI) 1.53-4.39, p=0.001] and extrathyroidal extension (HR 1.95, CI 1.12-3.38, p=0.018). Conclusion: An increase in the number of tumors is associated with a tendency toward more aggressive features and predicts poor prognosis in PTC.

AB - Background: Papillary thyroid cancer (PTC) often presents as multifocal. However, the association of multifocality with poor prognosis remains controversial. The aim of this retrospective study was to identify the characteristics of PTC with multiple foci and to evaluate the association between multifocality and prognosis. Methods: We reviewed the medical records of 496 patients who underwent total thyroidectomy for PTC. Patients were classified as G1 (1 tumor focus), G2 (2 foci), and G3 (3 or more foci). We analyzed the clinicopathological features and clinical outcomes in each classification. A Cox regression model was used to assess the relationship between multifocality and recurrence or cancer mortality. Results: The G1, G2 and G3 groups included 287, 141 and 68 patients, respectively. The mean age was 47.1±16.1 yr in G1, 41.1±18.4 yr in G2, and 35.5±15.9 yr in G3 and differed significantly among the 3 groups (p=0.001). The proportion of extrathyroidal extension, central lymph node metastasis (CLNM), and lateral lymph node metastasis (LLNM) in the G1 to G3 groups increased with increasing number of tumor foci. The Kaplan-Meier curves revealed that G3 had the shortest recurrence-free survival, and differences were significant among the 3 groups (p=0.001, Log Rank test). Furthermore, cancer-specific survival rates decreased significantly with increasing number of tumor foci (p=0.041). Independent predictors of recurrence by multivariate Cox analysis included >3 tumor foci [HR 2.60, 95% confidence interval (CI) 1.53-4.39, p=0.001] and extrathyroidal extension (HR 1.95, CI 1.12-3.38, p=0.018). Conclusion: An increase in the number of tumors is associated with a tendency toward more aggressive features and predicts poor prognosis in PTC.

KW - Mortality

KW - Multifocality

KW - Papillary thyroid carcinoma

KW - Recurrence

UR - http://www.scopus.com/inward/record.url?scp=84924935894&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84924935894&partnerID=8YFLogxK

U2 - 10.1186/1471-2407-14-914

DO - 10.1186/1471-2407-14-914

M3 - Article

C2 - 25471041

AN - SCOPUS:84924935894

VL - 14

JO - BMC Cancer

JF - BMC Cancer

SN - 1471-2407

IS - 1

M1 - 914

ER -