Open Access

Effects of tumor size on prognosis in differentiated thyroid carcinoma smaller than 2 cm

  • Authors:
    • Ting‑Ting Zhang
    • Cun‑Fu Li
    • Shi‑Shuai Wen
    • Dong‑Zhe Huang
    • Guo‑Hua Sun
    • Yong‑Xue Zhu
    • Yu Wang
    • Qing‑Hai Ji
    • Ning Qu
    • Rong‑Liang Shi
  • View Affiliations

  • Published online on: February 28, 2019     https://doi.org/10.3892/ol.2019.10088
  • Pages: 4229-4236
  • Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Benefits of subdividing small‑differentiated thyroid carcinoma (sDTC) by tumor size are controversial. We conducted a meta‑analysis to investigate whether tumor size is associated with prognosis of sDTC. PubMed and Web of Science databases were searched from their inception to September 2018. The identified studies according to the inclusion/exclusion criteria were analyzed using fixed/random‑effects models. Data were calculated and results of the meta‑analysis were expressed as odd ratio (OR). sDTC was classified as S1 (≤1 cm) and S2 (>1 cm and ≤2 cm). A systematic analysis was performed to compare the difference of recurrence, survival and clinicopathological factors between the two subgroups of sDTC (S1 vs. S2). A total of 21 studies published between 2004 and 2017 enrolling 219,291 patients were included. Findings showed that, S2 was associated with higher recurrence risk compared with S1 (OR=1.575, 95% CI=1.428‑1.738; P<0.05). There was no statistical difference in survival between S1 and S2, but significant statistical heterogeneity (OR=1.160, 95% CI=0.810‑1.662; P=0.448; I2=75.8%). Meta‑regression analysis revealed publication year potentially caused the heterogeneity (P<0.05). Comparison of small papillary thyroid carcinoma alone agreed with the results of sDTC. T1b increased the risk of recurrence (OR=1.520; 95% CI=1.072‑2.155; P<0.05) and death (OR=1.504; 95% CI 1.353‑1.672; P<0.05) compared with T1a. S2 associated with extrathyroidal extension (OR=2.575; 95% CI=1.603‑4.135; P<0.05), bilaterality (OR=2.278; 95% CI=1.905‑2.723; P<0.05), vascular invasion (OR=4.494; 95% CI=2.812‑7.183; P<0.05) and lymph node metastases (OR=1.12; 95% CI=1.10‑1.14; P<0.05). Our analysis suggested it is necessary to subdivide sDTC into S1 and S2 owing to their different effects on prognosis, especially recurrence.
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May-2019
Volume 17 Issue 5

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Spandidos Publications style
Zhang TT, Li CF, Wen SS, Huang DZ, Sun GH, Zhu YX, Wang Y, Ji QH, Qu N, Shi RL, Shi RL, et al: Effects of tumor size on prognosis in differentiated thyroid carcinoma smaller than 2 cm. Oncol Lett 17: 4229-4236, 2019
APA
Zhang, T., Li, C., Wen, S., Huang, D., Sun, G., Zhu, Y. ... Shi, R. (2019). Effects of tumor size on prognosis in differentiated thyroid carcinoma smaller than 2 cm. Oncology Letters, 17, 4229-4236. https://doi.org/10.3892/ol.2019.10088
MLA
Zhang, T., Li, C., Wen, S., Huang, D., Sun, G., Zhu, Y., Wang, Y., Ji, Q., Qu, N., Shi, R."Effects of tumor size on prognosis in differentiated thyroid carcinoma smaller than 2 cm". Oncology Letters 17.5 (2019): 4229-4236.
Chicago
Zhang, T., Li, C., Wen, S., Huang, D., Sun, G., Zhu, Y., Wang, Y., Ji, Q., Qu, N., Shi, R."Effects of tumor size on prognosis in differentiated thyroid carcinoma smaller than 2 cm". Oncology Letters 17, no. 5 (2019): 4229-4236. https://doi.org/10.3892/ol.2019.10088