SUMMARY OF THE STUDY
This study was carried on by doing a analysis of two large databases: The National Cancer Data Base (NCDB) and the Surveillance, Epidemiology, and End Results (SEER) program.
The NCDB is thought to capture approximately 85% of all new cancer cases in the US, and this study reviewed files from 1998 to 2012 to identify all thyroid cancer patients who had thyroid surgery. Data obtained included cancer size, age, sex, race/ethnicity and insurance status amongst others. The main outcome evaluated with this data base was overall survival.
The SEER program database is representative of approximately 28% of the American population and was used to find out the survival specific to thyroid cancer. Registries from 2004 to 2012 were used to identify all thyroid cancer patients who underwent thyroid surgery. Patients with cancers smaller than 2 cm were analyzed, and they were divided into two groups based on tumor size: T1a ( < 1 cm) and T1b ( 1-2 cm). The databases were not combined at any point for the analysis.
A total of 149,912 patients met study criteria and were included in the study. Of these, 65% had T1a tumors and 35% had T1b tumors. The analysis revealed that patients with T1b tumors were more likely to undergo a total thyroidectomy (88 % vs 74%), have positive surgical margins ( 8% vs 4%), have spread of the cancer to the neck lymph nodes (36% vs 24%) and receive RAI treatment (60% vs 28%) than patients with T1a tumors.
However, there was no difference in the two groups with respect to overall survival (95% for both groups at 10 years) , or survival specific to thyroid cancer ( 99.2% vs 98.7%) for the T1a and T1b groups respectively.
WHAT ARE THE IMPLICATIONS OF THIS STUDY?
This study shows that patients who have thyroid cancers with a size 1-2 cm tend to receive different treatment (more involved) than people who have cancers smaller than 1 cm but there is no significant difference in survival rates. This means that, moving forward, the current subdivision in the staging system by the AJCC within the T1 tumors may not be necessary. This study is important because it shows that many more patients may be able to choose and receive more conservative treatments for their tumors without compromising their survival from the disease.
— Jessie Block-Galarza
ATA THYROID BROCHURE LINKS
Thyroid Cancer (Papillary and Follicular): http://www.thyroid.org/thyroid-cancer/
Thyroid Cancer (Medullary): http://www.thyroid.org/ medullary-thyroid-cancer/
Radioactive Iodine: http://www.thyroid.org/ radioactive-iodine/
Thyroid Surgery: http://www.thyroid.org/thyroid-surgery/