Risk of Mortality between Untreated and Treated Papillary Thyroid Cancer: A Matched Cohort Analysis

• Published in: Annals of otology, rhinology & laryngology rhinology & laryngology, 2020-03, Vol.129 (3), p.265-272
• Main Authors: Lin, Jonathan K., Sakoda, Lori C., Darbinian, Jeanne, Socarras, Melissa, Chiao, Whitney, Calixto, Nathaniel, Quesenberry, Charles, Gurushanthaiah, Deepak, Wang, Kevin H., Durr, Megan
• Format: Article
• Language: English
• Subjects: Aged; California - epidemiology; Cohort Studies; Female; Humans; Male; Matched-Pair Analysis; Middle Aged; Neoplasm Metastasis; Propensity Score; Proportional Hazards Models; Retrospective Studies; Thyroid Cancer, Papillary - mortality; Thyroid Cancer, Papillary - therapy; Thyroid Neoplasms - mortality; Thyroid Neoplasms - therapy; Watchful Waiting
• ISSN: 0003-4894; 1943-572X
• DOI: 10.1177/0003489419885403

Objectives: To examine the association between treatment status and mortality risk among patients with papillary thyroid cancer (PTC). Methods: We identified 3,679 adults with PTC. Thirty-one untreated patients were matched to 155 treated patients. Hazards ratios (HR) and 95% confidence intervals (CIs) were calculated to estimate all-cause and disease-specific mortality. A low-risk subgroup was analyzed for differences in all-cause mortality. Results: The adjusted HRs (95% CIs) for all-cause mortality at 5 and 10 years were 4.2 (1.7-10.3) and 4.1 (1.9-9.4) and for disease- specific mortality were 14.1 (3.4-59.3) and 10.2 (2.9-36.4), respectively, for untreated versus treated patients. The adjusted HRs (95% CIs) for all- cause mortality was 0.7 (0.1-6.4) for low-risk untreated versus matched treated patients. Conclusions: Compared to treated patients, untreated PTC patients were at higher risk of death while low-risk untreated PTC patients had comparable rate of metastasis and no increased risk of all-cause mortality. Level of evidence: 3