Prognostic Value of Extranodal Extension in Thyroid Cancer: A Meta-Analysis.
OBJECTIVE
Thyroid cancer is the most common endocrine cancer and its incidence has continuously increased in the last three decades all over the world. We aimed to evaluate the prognostic value of extranodal extension (ENE) of thyroid cancer.


METHODS
We performed a systematic search of MEDLINE (from inception to June 2014) and EMBASE (from inception to June 2014) for English-language publication. The inclusion criteria were studies of thyroid cancer that reported the prognostic value of ENE in thyroid cancer. Reviews, abstracts, and editorial materials were excluded, and duplicate data were removed. Two authors performed the data extraction independently.


RESULTS
6 studies including 1830 patients were eligible for inclusion in the study. All patients included in the meta-analysis had papillary thyroid cancer (PTC). Recurrence-free survival was analyzed based on 3 studies. The pooled hazard ratio for recurrence was 2.01 [95% confidence interval (CI) 1.19-3.40, p=0.009]. Disease-specific survival was analyzed based on 3 studies with 973 patients. Patients of PTC with ENE showed 3.37-fold higher risk of death from the disease (95% CI 1.55-7.32, p=0.002).


CONCLUSIONS
ENE should be considered to be a poor prognostic marker in thyroid cancer; such knowledge might improve the management of individual patients. This might facilitate the planning of appropriate ablation therapy and tailored patient follow-up from the beginning of treatment.
Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
Sunghwan
S
Suh
Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Kyoungjune
K
Pak
Department of Nuclear Medicine, Chung-Ang University College of Medicine, Seoul, Korea. ethmoid@daum.net.
Ju Won
JW
Seok
Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. pnuhnm@gmail.com.
In Joo
IJ
Kim
D002277:Carcinoma / Q000401:mortality* / Q000556:secondary* / Q000601:surgery; D002291:Carcinoma, Papillary; D018572:Disease-Free Survival; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D016016:Proportional Hazards Models; D012306:Risk; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome
Thyroid carcinoma; lymph nodes; prognosis