Research Papers:
Paradoxes in thyroid carcinoma treatment: analysis of the SEER database 2010-2013
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Abstract
Ping Zhou1, Shuangming Tian1, Jiale Li1, Yongfeng Zhao1, Wengang Liu1, Yan Zhang1, Zheyu Hu1,2
1Department of Ultrasound, the Third Xiangya Hospital of Central South University, China
2Information Security and Big Data Institution, Central South University, China
Correspondence to:
Zheyu Hu, email: [email protected]
Keywords: thyroid carcinoma, epidemiology and end results (SEER) database, surgery and radiation treatment, cox regression model, propensity score
Received: October 04, 2016 Accepted: November 09, 2016 Published: November 16, 2016
ABSTRACT
Thyroid cancer is a common malignant disease with high survival rate (98.1%, 2006-2012, Surveillance Epidemiology and End Results (SEER) program). In this study, we investigated the treatment paradoxes in thyroid T0 and micro-carcinoma patients. 48,234 thyroid carcinoma patients were identified from 2010 to 2013 in SEER*Stat database (version 8.2.1) released in 2016. Survival analysis showed a significantly lower thyroid carcinoma-specific survival in T0 patients compared with T1–T3 patients. In propensity score analysis, T0 patients had a similar survival curve with T1-T3 patients when lymph node and distant metastasis stages were matched. When all variables, including radiation and surgery treatment, were matched, T0 patients had significantly higher survival compared to T3 patients. These findings suggested that more metastasis and less treatment led to poorer prognosis in T0 patients. Another paradox is about thyroid micro-carcinoma. The survival rate of micro-carcinoma patients was high (4 years survival rate was 99.92%), and more than 99% micro-carcinoma patients received surgery. Interestingly, all the patients who died because of thyroid carcinoma received surgery. Survival analysis showed no difference in survival when patients stratified by surgery or radiation. In conclusion, we suggested paradoxes in thyroid carcinoma treatment: over-treated in micro-carcinoma patients and less-treated in T0 patients.
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