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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Interaction between tumor stage and age on survival outcomes of patients with anaplastic thyroid cancer
Ayrton I Bangolo, Auda Auda, John Bukasa-Kakamba, Nayan Bhakta, Shraboni Dey, Anupriya lilhori, Gowry Reddy, Budoor Alqinai, Aman Sidiqui, Imranjot Sekhon, Barbare Khatiashvili, Iqra Abbas, Sandra Kunnel, Amer Jarri, Emelyn Martinez, Deborah Daoud, Ishita Gupta, Harshini Gompa, Silvanna Pender, Dana Aljaberi, Hamed Aljanaahi, Sandra S Kunnel, Yingxia Xiao, Yoontae Jung, Sneha Nagpaul, Afshan Naz, Tejaswee Mallela, Phyo Maung Maung, Ibtihal Y Khalaf, Soobee Kim, Roua Alrestom, Aditya Gajera, Hiba Alkealy, Deepti Kansal, Sonam Dhall, Sanya Satheesha, Simcha Weissman, Pierre Fwelo
Ayrton I Bangolo, Shraboni Dey, Budoor Alqinai, Aman Sidiqui, Imranjot Sekhon, Amer Jarri, Silvanna Pender, Sneha Nagpaul, Sanya Satheesha, Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
Auda Auda, Nayan Bhakta, Anupriya lilhori, Gowry Reddy, Barbare Khatiashvili, Iqra Abbas, Sandra Kunnel, Emelyn Martinez, Deborah Daoud, Ishita Gupta, Harshini Gompa, Dana Aljaberi, Hamed Aljanaahi, Sandra S Kunnel, Yingxia Xiao, Yoontae Jung, Afshan Naz, Tejaswee Mallela, Phyo Maung Maung, Ibtihal Y Khalaf, Soobee Kim, Roua Alrestom, Aditya Gajera, Hiba Alkealy, Deepti Kansal, Sonam Dhall, Simcha Weissman, Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
John Bukasa-Kakamba, Department of Endocrine and Metabolic Disorders, University of Kinshasa, Kinshasa Kinshasa, Congo
Pierre Fwelo, Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, TX 77030, United States
Author contributions: Bangolo A and Fwelo P designed the research study; Bangolo A, Auda A, Bukasa-Kakamba J, Bhakta N, Dey S, Lilhori A, Reddy G, Alqinai B, Sidiqui A, Sekhon I, Khatiashvili B, Abbas I, Kunnel S, Jarri A, Martinez E, Daoud D, Gupta I, Gompa H, Pender S, Aljaberi D performed the research; Bangolo A, Aljanaahi H, Kunnel SS, Xiao Y, Jung Y, Nagpaul S, Naz A, Mallela T, Maung PM, Khalaf IY, Kim S, Alrestom R, Gajera A, Alkealy H, Kansal D, Dhall S, Satheesha S, Weissman S analyzed the data and wrote the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: No potential conflict of interest was reported by the authors.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Ayrton I Bangolo, MBBS, MD, Doctor, Department of Internal Medicine, Palisades Medical Center, 7600 River Road, North Bergen, NJ 07047, United States.
ayrtonbangolo@yahoo.com
Received: March 7, 2024
Revised: June 13, 2024
Accepted: June 25, 2024
Published online: September 20, 2024
Processing time: 175 Days and 3.4 Hours
BACKGROUND
Anaplastic thyroid cancer (ATC) is an aggressive, rare malignancy associated with rapid growth and metastasis, and a very poor prognosis. We investigated the clinical characteristics, survival outcomes and independent prognostic factors associated with anaplastic thyroid cancer.
AIM
To assess to what extent the interaction between age and tumor stage affects mortality.
METHODS
A total of 622 patients diagnosed with anaplastic thyroid cancer, between 2010 and 2017 were enrolled in our study by retrieving data from the Surveillance, Epidemiology and End Results (SEER) database. We analyzed demographics, clinical characteristics, overall mortality (OM) and cancer specific mortality (CSM) of ATC. Variables with a P value < 0.1 were incorporated into the multivariate cox model to determine the independent prognostic factors. Furthermore, we analyzed the interaction between age and tumor stage on mortality.
RESULTS
In the multivariate analyses, the divorced/separated population had a lower OM [hazard ratio (HR) = 0.63, 95%CI: 0.42-0.94, P < 0.05] and CSM (HR = 0.61, 95%CI: 0.40-0.92, P < 0.05). OM was higher in tumors with direct extension only (HR = 6.26, 95%CI: 1.29-30.42, P < 0.05) and tumors with distant spread (HR = 5.73, 95%CI: 1.34-24.51, P < 0.05). CSM was also higher in tumors with direct extension (HR = 5.05, 95%CI: 1.05-24.19, P < 0.05) and tumors with distant spread (HR = 4.57, 95%CI: 1.08-19.29, P < 0.05). Mortality was not adversely affected by lymph node involvement. OM was lower in patients who received radiation (HR = 0.66, 95%CI: 0.53-0.83, P < 0.01), chemotherapy (HR = 0.63, 95%CI: 0.50-0.79, P < 0.01) or surgery (HR = 0.53, 95%CI: 0.43-0.66, P < 0.01). CSM was also lower in patient who received radiation (HR = 0.64, 95%CI: 0.51-0.81, P < 0.01), chemotherapy (HR = 0.62, 95%CI: 0.50-0.78, P < 0.01) or surgery (HR = 0.51, 95%CI: 0.41-0.63, P < 0.01). There was no significant interaction between age and tumor stage that affected mortality.
CONCLUSION
In this large US SEER database retrospective study, we found the mortality to be higher in advanced stage tumors with direct extension and distant metastasis. However, patients who received aggressive therapy showed a better overall survival. The aim of our study is to emphasize the importance of detecting ATC at an early stage and provide aggressive therapy to these patients. Since advanced stage ATC is associated with a dismal prognosis, we emphasize the need for randomized control trials and development of novel therapies that will be used to treat ATC.
Core Tip: Anaplastic thyroid cancer (ATC) represents a rare and highly aggressive subtype of thyroid cancer. Due to its rarity, limited information exists regarding the survival outcomes of patients with ATC. This study aims to provide the most current and comprehensive analysis of survival outcomes among ATC patients, with a specific emphasis on the interaction between two independent prognostic factors. Our findings indicate higher mortality rates in cases of advanced-stage tumors with direct extension and distant metastasis. Nevertheless, patients who underwent aggressive therapy exhibited improved overall survival rates.
