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Head Neck. 2019 Jan 16. doi: 10.1002/hed.25596. [Epub ahead of print]

Significant racial differences in the incidence and behavior of the follicular variant of papillary thyroid carcinoma.

Author information

1
Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York.
2
Department of Pathology, Montefiore Medical Center, Bronx, New York.
3
Gangdong Hana ENT clinic, Hana ENT Hospital, Seoul, South Korea.
4
Department of Surgery, Montefiore Medical Center, Bronx, New York.
5
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.

Abstract

BACKGROUND:

Increased detection of papillary thyroid cancer (PTC) has led to overtreatment of the largely indolent follicular variant (fvPTC). To guide management of non-aggressive lesions, we investigated whether race predicts PTC variant and tumor behavior.

METHODS:

Analysis of 258 973 patients from the National Cancer Database diagnosed with PTC in 2004-2014. Clinical and tumor information was compared by race. Multivariate logistic regression was used to predict fvPTC, extrathyroidal extension (ETE), and lymph node metastasis (LNM) of fvPTC.

RESULTS:

Blacks had the highest fvPTC rate (40% vs white 30%, Hispanic 26%, Asian 25%, P < .001). Blacks had higher odds of fvPTC (aOR = 1.33, 95% CI: 1.28-1.37) and lower odds of ETE than whites (aOR = 0.90, 95% CI: 0.82-0.99) (P < .001). Hispanics and Asians had lower odds of fvPTC (aOR = 0.89, 95% CI: 0.86-0.92 and aOR = 0.81, 95% CI: 0.79-0.84) and higher odds of LNM and ETE than whites (P < .001).

CONCLUSIONS:

Racial disparities in fvPTC incidence and behavior should be considered to optimize diagnosis and treatment planning.

KEYWORDS:

endocrine gland neoplasms; follicular variant; histologic variants; papillary thyroid cancer; thyroid cancer

PMID:
30652370
DOI:
10.1002/hed.25596

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