Tumor differentiation-dependent conditional survival of patients with operable thyroid cancer.

Abstract

Objective: Little is known about the changing risk profile of death and conditional survival in patients with operable thyroid cancer. This study aimed to investigate the annual hazard rate of cancer death, actuarial disease-specific survival (DSS), and conditional DSS in patients with thyroid cancer and explore the effects of tumor differentiation.

Methods: Patients diagnosed with thyroid cancer (N = 132,354) between 2004 and 2019 were identified from the Surveillance, Epidemiology, and End Results database. The hazard function was used to estimate the annual hazard rate of death. The Kaplan-Meier method and log-rank test were used for the calculation and between-group comparison of actuarial DSS, respectively. The life table was used to estimate the conditional DSS.

Results: A total of 1896 (1.4%) patients died due to thyroid cancer during the follow-up period. Patients with ATC (68.9%, 313/454) were more likely to die than those with PDTC (19.4%, 171/883) or DTC (1.1%, 1412/131017). For the entire cohort, patients with DTC and PDTC had excellent and relatively stable one-year conditional survival, respectively; patients with ATC had the worst one-year conditional survival, but they achieved the greatest improvements. The worst one-year conditional survival and the most obvious improvement were seen in patients with ATC regardless of any SEER Summary Stage.

Conclusion: Prognosis improved over time in a tumor differentiation-dependent manner in patients with operable thyroid cancer after diagnosis. This information provides more precise dynamic evaluations of the long-term prognosis of thyroid cancer survivors and paramount clinical implications for individualized treatment and surveillance.