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Clinicopathological Risk Factors for Distant Metastasis in Differentiated Thyroid Carcinoma: A Meta-analysis

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Abstract

Introduction

Distant metastasis (DM) is not a frequent event in differentiated thyroid carcinoma (DTC) but has an adverse impact on mortality of patients with DTC. In the current study, we aimed to conduct a comprehensive systematic review and meta-analysis to investigate the risk factors for DM in DTCs and for each histological subtype.

Methods

Five electronic databases were searched from inception to December 2016 for relevant articles. Pooled odd ratios and 95% confidence interval were calculated using random-effect model.

Results

Thirty-four articles with 73,219 patients were included for meta-analyses. In DTCs, male gender, age ≥45 years, tumor size ≥4 cm, multifocality, vascular invasion (VI), extrathyroidal extension (ETE), lymph node metastasis (LNM), and lateral LNM were demonstrated to be associated with significant risks for DM. In addition, several clinicopathological factors such as age ≥45 years, VI, ETE, and LNM were shown to be significant risk factors for DM in both PTC and FTC subgroups.

Conclusion

Our study demonstrated the promising value of several clinicopathological factors such as male gender, older age, VI, ETE, and LNM in predicting DM in PTCs and FTCs. Our study affirms the value of the selected clinicopathological factors for tumor risk stratification and assessment of patients’ prognosis.

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Authors and Affiliations

  1. Department of Pathology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan

    Huy Gia Vuong, Naoki Oishi, Kunio Mochizuki, Tadao Nakazawa, Ryohei Katoh & Tetsuo Kondo

  2. Department of Pathology, Cho Ray Hospital, Ho Chi Minh City, 70000, Vietnam

    Huy Gia Vuong & Thong Quang Pham

  3. Pham Ngoc Thach University of Medicine, Ho Chi Minh City, 70000, Vietnam

    Uyen N. P. Duong

  4. Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, 70000, Vietnam

    Hung Minh Tran

  5. Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA

    Lewis Hassell

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  1. Huy Gia Vuong
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Correspondence to Tetsuo Kondo.

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Vuong, H.G., Duong, U.N.P., Pham, T.Q. et al. Clinicopathological Risk Factors for Distant Metastasis in Differentiated Thyroid Carcinoma: A Meta-analysis. World J Surg 42, 1005–1017 (2018). https://doi.org/10.1007/s00268-017-4206-1

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