This article is more than 5 years old. Information may no longer be current.
Secondary thyroid cancer decreased OS among adolescents, young adults
Adolescents and young adults with secondary thyroid cancer have more than six times the risk for death compared with those who have primary thyroid cancer, according to study results.
Melanie Goldfarb, MD, of the University of Southern California Keck School of Medicine, and David Freyer, DO, MS, of Children’s Hospital Los Angeles, identified 41,062 patients aged 15 to 39 years with thyroid cancer in the 1998 to 2010 American College of Surgeons National Cancer Database. Of those individuals, 1,349 (3.3%) had thyroid cancer as a secondary malignant neoplasm.
Melanie Goldfarb
Secondary thyroid cancer occurred more frequently than primary thyroid cancers among non-Hispanic whites (OR=2.643; 95% CI, 1.31-5.331) and patients aged 35 to 39 years (OR=1.239; 95% CI, 1.093-1.404). Secondary thyroid cancers occurred less frequently than primary thyroid cancers among females (OR=0.608; 95% CI, 0.534-0.692), as well as patients aged 15 to 19 years (OR=0.624; 95% CI, 0.51-0.763) and 25 to 29 years (OR=0.711; 95% CI, 0.604-0.837).
Secondary thyroid cancers also were more likely to be multifocal (OR=1.173; 95% CI, 1.049-1.313) and to have tall or columnar cell histology (OR=2.187; 95% CI, 0.534-0.692). More secondary thyroid cancers were microcarcinomas smaller than 1 cm (OR=1.496; 95% CI, 1.327-1.687), and fewer were larger than 4 cm (OR=0.61; 95% CI, 0.493-0.758).
Analyses adjusted for patient demographics, tumor and thyroid treatment factors indicated a 6.63-fold (95% CI, 4.97-8.86) increased risk for death for secondary vs. primary thyroid cancer.
OS with secondary thyroid cancer worsened among patients who were Hispanic (HR=4.23; 95% CI, 2.266-7.898), as well as those who had distant metastases (HR=13.032; 95% CI, 4.01-42.35) and tall or columnar cell histology (HR=5.295; 95% CI, 1.898-14.773).
“This study will hopefully spur future research that will investigate if there are any causes — biologic, environmental, prior treatment-related, or access-to care-disparities — to account for the survival differences in these secondary cancers,” Goldfarb said in a press release.
Disclosure: The researchers report no relevant financial disclosures.