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

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...

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Bibliographic Details
Published in:World journal of surgery 2018-04, Vol.42 (4), p.1005-1017
Main Authors: Vuong, Huy Gia, Duong, Uyen N. P., Pham, Thong Quang, Tran, Hung Minh, Oishi, Naoki, Mochizuki, Kunio, Nakazawa, Tadao, Hassell, Lewis, Katoh, Ryohei, Kondo, Tetsuo
Format: Article
Language:English
Subjects:
Abdominal Surgery
Age
Cardiac Surgery
Confidence intervals
General Surgery
Medicine
Medicine & Public Health
Meta-analysis
Metastases
Metastasis
Patients
Risk analysis
Risk factors
Scientific Review
Subgroups
Surgery
Systematic review
Thoracic Surgery
Thyroid
Thyroid cancer
Thyroid carcinoma
Vascular Surgery
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Summary: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.
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-017-4206-1