Table 3.
Predictive Factors for Distant Metastases and Disease Persistence at the End of Follow-Up in Differentiated Thyroid Carcinomas
| Distant Metastases (n = 294) |
Persistent Disease (n = 211) |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Presence (%) | Univariate Analysis |
Multivariate Analysis |
Presence (%) | Univariate Analysis |
Multivariate Analysis |
|||||
| OR (95% CI) | P Value | OR (95% CI) | P Value | OR (95% CI) | P Value | OR (95% CI) | P Value | |||
| Total | 44 (15.0) | 58 (27.5) | ||||||||
| Age, y | ||||||||||
| <45 | 17 (11.5) | 1 (Referent) | NS | 25 (22.9) | 1 (Referent) | NS | ||||
| ≥45 | 27 (18.5) | 1.75 (0.91–3.37) | (.09) | 33 (32.4) | 1.61 (0.87–2.96) | (.13) | ||||
| Gender | ||||||||||
| Female | 28 (12.4) | 1 | .02 | 1 | .03 | 42 (24.9) | 1 | .04 | 1 | .03 |
| Male | 16 (24.6) | 2.31 (1.16–4.60) | 2.32 (1.10–4.90) | 16 (41.0) | 2.10 (1.02–4.35) | 2.46 (1.11–5.47) | ||||
| Tumor sizea | 1.28 (1.07–1.54) | .009 | 1.18 (0.97–1.44) | .10 | 1.18 (0.97–1.43) | NS (.10) | ||||
| Extrathyroidal extension | ||||||||||
| No | 14 (15.1) | 1 | NS | 22 (24.4) | 1 | NS | ||||
| Yes | 22 (14.3) | 0.94 (0.46–1.94) | (.87) | 28 (35.9) | 1.73 (0.89–3.27) | (.11) | ||||
| Vascular invasion | ||||||||||
| No | 10 (7.2) | 1 | <.001 | b | 16 (20.0) | 1 | NS | |||
| Yes | 22 (23.4) | 3.94 (1.77–8.78) | 22 (32.8) | 1.96 (0.93–4.13) | (.08) | |||||
| Lymph node metastases | ||||||||||
| N0/Nx | 17 (17.9) | 1 | NS | 21 (23.3) | 1 | .04 | 1 | .03 | ||
| N1 | 27 (15.7) | 0.85 (0.44–1.66) | (.64) | 35 (37.2) | 1.95 (1.03–3.71) | 2.16 (1.10–4.25) | ||||
| BRAFc | ||||||||||
| wt | 21 (17.2) | 1 | NS | 20 (22.7) | 1 | NS | ||||
| V600E | 14 (12.1) | 0.66 (0.32–1.37) | (0.26) | 26 (37.1) | 2.00 (1.00–4.03) | (.05) | ||||
| TERT | ||||||||||
| wt | 34 (12.5) | 1 | <.001 | 1 | .002 | 48 (24.6) | 1 | .001 | 1 | .007 |
| mut | 10 (43.5) | 5.36 (2.18–13.18) | 4.60 (1.73–12.21) | 10 (62.5) | 5.10 (1.76–14.78) | 4.68 (1.54–14.27) | ||||
Abbreviations: mut, mutated; n, number of patients with available data for each feature; NS, not significant; wt, wild type. Bold values indicate the result was statistically significant.
Tumor size was included in the model as a continuous variable.
Vascular invasion was not considered in the multivariate model displayed in the table. The OR of TERT promoter mutations for distant metastases adjusted for gender was 5.61 (2.24–16.06) (P = .001); the OR of TERT promoter mutations adjusted for tumor size was 4.30 (1.66–11.13) (P = .003); the OR of TERT promoter mutations adjusted for vascular invasion was 3.54 (1.06–11.82) (P = .04); the OR of TERT promoter mutations adjusted for vascular invasion and gender was 3.51 (1.05–11.72) (P = .04). When all the features associated with distant metastases in the univariate model (gender, tumor size, TERT mutational status, and vascular invasion) were included in the multivariate model, vascular invasion was the only independent predictor of distant metastases, with an OR adjusted for age, tumor size, gender, and TERT of 3.38 (1.42–8.04).
BRAF analysis was performed only in the group of PTC.