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Strap muscle invasion in differentiated thyroid cancer does not impact disease-specific survival: a population-based study

 Ja Kyung Yoon  ;  Jandee Lee  ;  Eun-Kyung Kim  ;  Jung Hyun Yoon  ;  Vivian Youngjean Park  ;  Kyunghwa Han  ;  Jin Young Kwak 
 SCIENTIFIC REPORTS, Vol.10(1) : 18248, 2020-10 
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The American Joint Committee on Cancer (AJCC) 8th TNM staging system of differentiated thyroid cancer defines gross strap muscle invasion as T3b stage. However, the impact of strap muscle invasion on disease-specific survival (DSS) remains controversial. To elucidate the survival impact of strap muscle invasion of any degree in thyroid cancers, the Surveillance, Epidemiology, and End Results (SEER) database (1973-2018) was queried for thyroid cancer only patients on July 2019 (n = 19,914). The Cox proportional hazard analysis with multivariable adjustment revealed that strap muscle invasion was not a significant factor for DSS in tumors equal to or smaller than 40 mm (hazard ratio (HR) = 1.620 [confidence interval (CI) 0.917 - 2.860]; p = 0.097). The competing risk analysis with multivariable adjustment showed that strap muscle invasion did not significantly impact DSS regardless of tumor size or cause of death (cancer-caused death (Subdistribution HR (SDHR) = 1.567 [CI 0.984 - 2.495]; p = 0.059); deaths to other causes (SDHR = 1.155 [CI 0.842 - 1.585]; p = 0.370). A "modified" staging schema discarding strap muscle invasion as a T stage criterion showed better 10-year DSS distinction between T stages. The modified staging schema may better reflect cancer-caused death risk and may prevent potential overstaging.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Jin Young(곽진영) ORCID logo https://orcid.org/0000-0002-6212-1495
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Park, Vivian Youngjean(박영진) ORCID logo https://orcid.org/0000-0002-5135-4058
Yoon, Ja Kyung(윤자경) ORCID logo https://orcid.org/0000-0002-3783-977X
Yoon, Jung Hyun(윤정현) ORCID logo https://orcid.org/0000-0002-2100-3513
Lee, Jan Dee(이잔디) ORCID logo https://orcid.org/0000-0003-4090-0049
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