Unexpected high-risk pathologic features following thyroidectomy in the chinese immigrant population

Authors

Arvind K. Badhey, Department of Otolaryngology, Institute for Healthcare Delivery Science, Tisch Cancer Institute (TCI), Icahn School of Medicine at Mount Sinai, New York, New York.
Erin Moshier, Department of Population Health Science and Policy, Institute for Healthcare Delivery Science, Tisch Cancer Institute (TCI), Icahn School of Medicine at Mount Sinai, New York, New York.
Ameya Jategaonkar, Department of Otolaryngology, Institute for Healthcare Delivery Science, Tisch Cancer Institute (TCI), Icahn School of Medicine at Mount Sinai, New York, New York.
Anni Wong, Department of Otolaryngology, Institute for Healthcare Delivery Science, Tisch Cancer Institute (TCI), Icahn School of Medicine at Mount Sinai, New York, New York.
Kristen Echanique, Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.
Raymond L. Chai, Department of Otolaryngology, Institute for Healthcare Delivery Science, Tisch Cancer Institute (TCI), Icahn School of Medicine at Mount Sinai, New York, New York.

Document Type

Article

Abstract

OBJECTIVE: To compare rates of unexpected high-risk pathologic features between Chinese and non-Asian patients who underwent thyroidectomy for papillary thyroid cancer. METHODS: This was a retrospective cohort study at a tertiary academic urban medical center. Patients who underwent thyroidectomy for papillary carcinoma from 2015 to 2017 were included. Patient demographics, tumor characteristics, and tumor histopathology were analyzed. Primary outcome was the presence of adverse histopathologic features such as lymphovascular invasion (LVI) or microscopic/minimal extrathyroidal extension (mETE). Differences between the groups were analyzed using multivariate logistical regression analysis and propensity score-weighted analysis. RESULTS: One hundred seventy-nine patients were included: 58 Chinese-born and 121 non-Asian. The median age of the cohort was 47 years old (36-58). Twenty-nine percent of patients were male, and 71% were female. There was no statistically significant difference between the two cohorts in rates of LVI, multifocality, extent of surgery, or presence of thyroiditis. Patients with mETE were more likely to have larger tumors (P = 0.00247). Both the multivariate and propensity-weighted models demonstrated that Chinese ancestry was independently associated with an increased rate of unexpected mETE (adjusted prevalence ratio, 2.52; 95% confidence interval, 1.82-3.48). CONCLUSION: mETE is significantly higher in the immigrant Chinese compared to the non-Asian population. Given the high prevalence of unexpected mETE in the Chinese population, the added risk of this finding should be brought into the discussion during initial surgical planning. LEVEL OF EVIDENCE: 3 Laryngoscope, 130:1844-1849, 2020.

Medical Subject Headings

Adult; China (epidemiology); Emigrants and Immigrants; Female; Follow-Up Studies; Humans; Male; Middle Aged; Postoperative Complications (ethnology); Prevalence; Prognosis; Retrospective Studies; Risk Assessment (methods); Risk Factors; Thyroid Cancer, Papillary (ethnology, surgery); Thyroid Neoplasms (ethnology, surgery); Thyroidectomy (adverse effects)

Publication Date

7-1-2020

Publication Title

The Laryngoscope

E-ISSN

1531-4995

Volume

130

Issue

7

First Page

1844

Last Page

1849

PubMed ID

31593307

Digital Object Identifier (DOI)

10.1002/lary.28319

Recommended Citation

Badhey, Arvind K.; Moshier, Erin; Jategaonkar, Ameya; Wong, Anni; Echanique, Kristen; and Chai, Raymond L., "Unexpected high-risk pathologic features following thyroidectomy in the chinese immigrant population" (2020). ENT and Skull Base Surgery. 16.
https://scholar.barrowneuro.org/ent-and-skull-base-surgery/16