American journal of surgery · 2026
Data-driven thresholds for tumor size and nodal involvement in oncocytic thyroid carcinoma: A population-based analysis.
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Milan Milanie, Thomas Samantha M, Lindsay Christina V, Frieze Todd W, Scheri Randall P, Kazaure Hadiza S
Аннотация
INTRODUCTION: We sought to identify prognostically meaningful thresholds for tumor size and lymph node (LN) metastasis as a first step toward developing a dedicated staging system for oncocytic thyroid carcinoma (OTC).
METHODS: Using SEER (2004-2022), tumor size and LN thresholds for OTC were analyzed using restricted cubic splines; Cox models estimated association with overall (OS) and disease-specific survival (DSS).
RESULTS: Among 4114 patients, median tumor size was 34 mm, and 1410 (34.3%) had ≥1 LN examined. Tumor size showed a linear relationship with OS and DSS (no prognostic threshold). LN positivity showed thresholds of 2.42 positive LNs for OS and 2.14 for DSS; thus, ≥3 positive LNs was considered a prognostic threshold. Patients with ≥3 vs < 3 positive LNs had lower adjusted DSS (HR 3.32; p < 0.001) and OS (HR 2.65; p < 0.001).
CONCLUSION: For OTC, ≥3 positive LNs constituted a prognostic threshold, while tumor size conferred continuous risk.
METHODS: Using SEER (2004-2022), tumor size and LN thresholds for OTC were analyzed using restricted cubic splines; Cox models estimated association with overall (OS) and disease-specific survival (DSS).
RESULTS: Among 4114 patients, median tumor size was 34 mm, and 1410 (34.3%) had ≥1 LN examined. Tumor size showed a linear relationship with OS and DSS (no prognostic threshold). LN positivity showed thresholds of 2.42 positive LNs for OS and 2.14 for DSS; thus, ≥3 positive LNs was considered a prognostic threshold. Patients with ≥3 vs < 3 positive LNs had lower adjusted DSS (HR 3.32; p < 0.001) and OS (HR 2.65; p < 0.001).
CONCLUSION: For OTC, ≥3 positive LNs constituted a prognostic threshold, while tumor size conferred continuous risk.