ORIGINAL RESEARCH article
Front. Oncol.
Sec. Surgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1540705
Association between types of surgery and cancer-specific death in patients with early differentiated thyroid carcinoma: a real-world study
Provisionally accepted
- Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, China
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Objective: To explore the association between types of surgery and outcomes in patients with early differentiated thyroid carcinoma (DTC) by a real-world study.Methods: All the data were from Surveillance, Epidemiology, and End Results (SEER). Types of surgery included Surgery 1 (lobectomy, isthmectomy, or removal of less than a lobe), Surgery 2 (subtotal or near total thyroidectomy, or removal of a lobe and partial removal of the contralateral lobe), and Surgery 3 (total thyroidectomy). The association between types of surgery and DTC or other causes of death was explored by a competitive risk model and subgroup analysis. We also used the machine learning algorithm to evaluate the importance of types of surgery on long-term outcomes.Results: A total of 7,230 patients were enrolled, of whom 1,512, 249, and 5,469 patients received Surgery 1, Surgery 2, and Surgery 3, respectively. The long-term outcomes among the three groups differed significantly (P < 0.001). Competitive risk analysis showed that types of surgery were significantly associated with DTC-related death (P=0.005), other causes death (P<0.001) in the crude model, and three adjusted models further indicated their independent association (all adjusted P<0.05). Specifically, Surgery 2 was associated with the highest DTC-related death. However, when the death of other causes was refined, types of surgery were only related to DTC-related death (all adjusted P<0.05). The importance analysis suggested that the impact of surgical type on long-term outcomes may be underrecognized. Conclusions: The types of surgery were significantly related to the DTC-related death of patients, and it deserved attention. Additionally, Surgery 2 was associated with higher DTC-related death.
Keywords: Differentiated thyroid carcinoma, Surgery, Outcome, SEER, Competitive risk model
Received: 24 Dec 2024; Accepted: 30 Jun 2025.
Copyright: © 2025 Yu, Pang, Liu, Zhang and Kong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ling-yu Kong, Harbin Medical University Cancer Hospital, Harbin, 150081, Heilongjiang Province, China
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