Strap muscle invasion in differentiated thyroid cancer does not impact disease-specific survival: a population-based study

Ja Kyung Yoon, Jandee Lee, Eunkyung Kim, Jung Hyun Yoon, Vivian Youngjean Park, Kyunghwa Han, Jin Young Kwak

Research output: Contribution to journalArticlepeer-review

Abstract

The American Joint Committee on Cancer (AJCC) 8th TNM staging system of differentiated thyroid cancer defines gross strap muscle invasion as T3b stage. However, the impact of strap muscle invasion on disease-specific survival (DSS) remains controversial. To elucidate the survival impact of strap muscle invasion of any degree in thyroid cancers, the Surveillance, Epidemiology, and End Results (SEER) database (1973–2018) was queried for thyroid cancer only patients on July 2019 (n = 19,914). The Cox proportional hazard analysis with multivariable adjustment revealed that strap muscle invasion was not a significant factor for DSS in tumors equal to or smaller than 40 mm (hazard ratio (HR) = 1.620 [confidence interval (CI) 0.917 – 2.860]; p = 0.097). The competing risk analysis with multivariable adjustment showed that strap muscle invasion did not significantly impact DSS regardless of tumor size or cause of death (cancer-caused death (Subdistribution HR (SDHR) = 1.567 [CI 0.984 – 2.495]; p = 0.059); deaths to other causes (SDHR = 1.155 [CI 0.842 – 1.585]; p = 0.370). A “modified” staging schema discarding strap muscle invasion as a T stage criterion showed better 10-year DSS distinction between T stages. The modified staging schema may better reflect cancer-caused death risk and may prevent potential overstaging.

Original languageEnglish
Article number18248
JournalScientific reports
Volume10
Issue number1
DOIs
Publication statusPublished - 2020 Dec 1

Bibliographical note

Publisher Copyright:
© 2020, The Author(s).

All Science Journal Classification (ASJC) codes

  • General

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