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

Ann Otol Rhinol Laryngol. 2020 Mar;129(3):265-272. doi: 10.1177/0003489419885403. Epub 2019 Oct 28.

Abstract

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.

Keywords: carcinoma; endocrine; head and neck; papillary; surveillance; thyroid.

MeSH terms

  • 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*