Associations between preoperative thyroid parameters, aggressive clinicopathological features and risk of recurrence in differentiated thyroid cancer
Objective The study aimed (1) to investigate the association between aggressive clinicopathological characteristics and the American Thyroid Association (ATA) recurrence risk classification in differentiated thyroid cancer (DTC) patients, and (2) to investigate the prognostic value of preoperative t...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2025-12-01
|
| Series: | Annals of Medicine |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2491153 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849769339510587392 |
|---|---|
| author | Lu Yu Xiao Chen Jiaqi Liu Hanyu Wang Hui Sun |
| author_facet | Lu Yu Xiao Chen Jiaqi Liu Hanyu Wang Hui Sun |
| author_sort | Lu Yu |
| collection | DOAJ |
| description | Objective The study aimed (1) to investigate the association between aggressive clinicopathological characteristics and the American Thyroid Association (ATA) recurrence risk classification in differentiated thyroid cancer (DTC) patients, and (2) to investigate the prognostic value of preoperative thyroid parameters.Methods A total of 3833 patients histologically confirmed DTC were recruited. Preoperative clinical and postoperative pathologic data were retrospectively collected. Participants were stratified into low recurrence risk and intermediate-to-high recurrence risk groups based on the ATA risk stratification system.Results The study cohort had a mean age of 48.87 ± 8.08 years, and 1,465 (76.82%) were female. Male (OR = 1.37, p = .024), aged 52 years and older (OR = 2.01, p < .001), larger tumor size (OR = 3.71, p = 0.011), nerve invasion (OR = 6.69, p = .004), margin involvement (OR = 5.46, p < .001), multifocality (OR = 3.71, p < .001), and bilaterality (OR = 3.95, p < .001) were identified as risk factors for a higher ATA recurrence risk classification, in addition to established factors such as lymph node metastasis and angioinvasion, after adjusting for potential confounding variables. Higher preoperative levels of free triiodothyronine (FT3), FT3 to free thyroxine (FT3/FT4), and lower thyroid feedback quantile-based index (TFQI) levels were associated with a higher ATA recurrence risk classification. The comprehensive predictive model incorporating these variables demonstrated excellent discrimination (AUC = 0.836). Furthermore, higher FT3/FT4 levels and lower TFQI levels were associated with higher risk of lymph node metastases and angioinvasion.Conclusions Factors such as male sex, older age, multifocality, bilaterality, margin involvement, nerve invasion, larger tumor size, and preoperative thyroid parameters serve as complementary predictors for higher ATA recurrence risk in DTC, in addition to conventional risk factors. These insights contribute to a more nuanced understanding and optimization of current risk stratification methodologies. |
| format | Article |
| id | doaj-art-c24bce6d304d4d38b6fc43325981577c |
| institution | DOAJ |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-c24bce6d304d4d38b6fc43325981577c2025-08-20T03:03:27ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2491153Associations between preoperative thyroid parameters, aggressive clinicopathological features and risk of recurrence in differentiated thyroid cancerLu Yu0Xiao Chen1Jiaqi Liu2Hanyu Wang3Hui Sun4Department of Endocrinology and Metabolism, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Endocrinology and Metabolism, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Endocrinology and Metabolism, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Endocrinology and Metabolism, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Endocrinology and Metabolism, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaObjective The study aimed (1) to investigate the association between aggressive clinicopathological characteristics and the American Thyroid Association (ATA) recurrence risk classification in differentiated thyroid cancer (DTC) patients, and (2) to investigate the prognostic value of preoperative thyroid parameters.Methods A total of 3833 patients histologically confirmed DTC were recruited. Preoperative clinical and postoperative pathologic data were retrospectively collected. Participants were stratified into low recurrence risk and intermediate-to-high recurrence risk groups based on the ATA risk stratification system.Results The study cohort had a mean age of 48.87 ± 8.08 years, and 1,465 (76.82%) were female. Male (OR = 1.37, p = .024), aged 52 years and older (OR = 2.01, p < .001), larger tumor size (OR = 3.71, p = 0.011), nerve invasion (OR = 6.69, p = .004), margin involvement (OR = 5.46, p < .001), multifocality (OR = 3.71, p < .001), and bilaterality (OR = 3.95, p < .001) were identified as risk factors for a higher ATA recurrence risk classification, in addition to established factors such as lymph node metastasis and angioinvasion, after adjusting for potential confounding variables. Higher preoperative levels of free triiodothyronine (FT3), FT3 to free thyroxine (FT3/FT4), and lower thyroid feedback quantile-based index (TFQI) levels were associated with a higher ATA recurrence risk classification. The comprehensive predictive model incorporating these variables demonstrated excellent discrimination (AUC = 0.836). Furthermore, higher FT3/FT4 levels and lower TFQI levels were associated with higher risk of lymph node metastases and angioinvasion.Conclusions Factors such as male sex, older age, multifocality, bilaterality, margin involvement, nerve invasion, larger tumor size, and preoperative thyroid parameters serve as complementary predictors for higher ATA recurrence risk in DTC, in addition to conventional risk factors. These insights contribute to a more nuanced understanding and optimization of current risk stratification methodologies.https://www.tandfonline.com/doi/10.1080/07853890.2025.2491153Differentiated thyroid cancerrisk of recurrenceAmerican Thyroid Association risk classificationpathologysensitivity to thyroid hormones |
| spellingShingle | Lu Yu Xiao Chen Jiaqi Liu Hanyu Wang Hui Sun Associations between preoperative thyroid parameters, aggressive clinicopathological features and risk of recurrence in differentiated thyroid cancer Annals of Medicine Differentiated thyroid cancer risk of recurrence American Thyroid Association risk classification pathology sensitivity to thyroid hormones |
| title | Associations between preoperative thyroid parameters, aggressive clinicopathological features and risk of recurrence in differentiated thyroid cancer |
| title_full | Associations between preoperative thyroid parameters, aggressive clinicopathological features and risk of recurrence in differentiated thyroid cancer |
| title_fullStr | Associations between preoperative thyroid parameters, aggressive clinicopathological features and risk of recurrence in differentiated thyroid cancer |
| title_full_unstemmed | Associations between preoperative thyroid parameters, aggressive clinicopathological features and risk of recurrence in differentiated thyroid cancer |
| title_short | Associations between preoperative thyroid parameters, aggressive clinicopathological features and risk of recurrence in differentiated thyroid cancer |
| title_sort | associations between preoperative thyroid parameters aggressive clinicopathological features and risk of recurrence in differentiated thyroid cancer |
| topic | Differentiated thyroid cancer risk of recurrence American Thyroid Association risk classification pathology sensitivity to thyroid hormones |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2491153 |
| work_keys_str_mv | AT luyu associationsbetweenpreoperativethyroidparametersaggressiveclinicopathologicalfeaturesandriskofrecurrenceindifferentiatedthyroidcancer AT xiaochen associationsbetweenpreoperativethyroidparametersaggressiveclinicopathologicalfeaturesandriskofrecurrenceindifferentiatedthyroidcancer AT jiaqiliu associationsbetweenpreoperativethyroidparametersaggressiveclinicopathologicalfeaturesandriskofrecurrenceindifferentiatedthyroidcancer AT hanyuwang associationsbetweenpreoperativethyroidparametersaggressiveclinicopathologicalfeaturesandriskofrecurrenceindifferentiatedthyroidcancer AT huisun associationsbetweenpreoperativethyroidparametersaggressiveclinicopathologicalfeaturesandriskofrecurrenceindifferentiatedthyroidcancer |