AI Article Synopsis
- The study investigates the impact of gross strap muscle invasion (gSMI) in differentiated thyroid cancer (DTC) patients, a factor that could influence patient prognosis, particularly regarding tumor size.
- The research involved a meta-analysis of 18 observational studies to evaluate the association between gSMI and outcomes like recurrence, disease-specific mortality, and lymph node metastasis.
- Findings indicate that patients with gSMI have worse prognostic outcomes, but this effect is less pronounced for tumors that are 4 cm or smaller, suggesting a need for careful treatment strategies based on tumor size.
Article Abstract
Objectives: The presence of extrathyroidal extension (ETE) in patients with differentiated thyroid cancer (DTC) serves as a significant prognostic indicator. Consequently, the staging of DTC is categorized into extensive ETE and gross ETE that solely impacts the strap muscles (gross strap muscle invasion [gSMI]). However, there is a lack of sufficient evidence concerning the relationship between gSMI and prognosis, particularly in terms of tumor size.
Methods: Relevant literature was searched in Medline, Embase, Cochrane Library, and KoreaMed. All procedures were conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and carried out by two independent reviewers. The meta-analysis utilized a random-effects model to account for the diversity of the studies. Risk of Bias for Nonrandomized Studies (RoBANS) version 2.0, an evaluation tool for non-randomized studies, was employed to assess the quality of the selected research. Clinical data from observational studies that examined the relationship between the degree of ETE and prognosis were gathered, and a meta-analysis was conducted.
Results: Eighteen observational studies were included in this analysis. Subgroup analyses were conducted for each outcome. The findings revealed that the recurrence rate (odds ratio [OR], 2.498), disease-specific mortality (risk ratio [RR], 2.984), overall mortality (RR, 1.361), and lymph node (LN) metastasis (OR, 5.355) were significantly higher in patients with gSMI than in those without ETE. However, when the analysis was restricted to tumors measuring 4 cm or smaller, no significant differences in prognostic outcomes were observed, with the exception of LN metastasis.
Conclusion: gSMI negatively impacts prognosis; however, this correlation diminishes with smaller tumor sizes. Thus, a more cautious approach is warranted during the treatment process.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626101 | PMC |
| http://dx.doi.org/10.21053/ceo.2024.00162 | DOI Listing |
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