{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T22:21:52Z","timestamp":1789078912491,"version":"build-2803163510"},"reference-count":48,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010792","name":"Tungs\u2019 Taichung MetroHarbor Hospital","doi-asserted-by":"publisher","award":["TTMHH-R113006"],"award-info":[{"award-number":["TTMHH-R113006"]}],"id":[{"id":"10.13039\/100010792","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Whether thyroidectomy confers a long-term survival advantage over non-surgical management in real-world practice remains uncertain. We primarily evaluated the association between surgery and all-cause mortality in thyroid cancer; specialty-stratified outcomes were prespecified as secondary, exploratory analyses. Methods: Using the TriNetX US Collaborative Network (2008\u20132024), we identified adults with thyroid cancer and created 1:1 propensity score-matched cohorts of patients who did or did not undergo thyroidectomy, balancing demographics, comorbidities, medications, and laboratory variables. Overall survival was assessed with Kaplan\u2013Meier curves and Cox proportional hazard models. Among the surgical patients, we performed exploratory analyses stratified by operating specialty (otolaryngology\u2013head and neck surgery (reference) vs. general\/endocrine surgery and other\/unknown, reported descriptively). Results: After matching, 49,219 patients were included per cohort. Thyroidectomy was associated with lower long-term mortality versus non-surgical care (adjusted HR 0.685, 95% CI 0.652\u20130.721). Among the surgical patients, secondary, exploratory specialty-stratified analyses suggested differences: compared with otolaryngology\u2013head and neck surgery (ENT\u2013HNS; reference), general\/endocrine surgery (GS\/ES) had a lower adjusted hazard of death (aHR 0.561, 95% CI 0.481\u20130.654), whereas other\/unknown specialties had a higher adjusted hazard (aHR 1.583, 95% CI 1.302\u20131.924). These patterns are hypothesis-generating and may reflect residual confounding, including the tumor stage and histology, referral pathways, and surgeon or center experience. Conclusions: In a large, propensity-matched real-world cohort, surgery was linked to improved long-term survival regarding thyroid cancer. Observed specialty-related variation should be interpreted cautiously, and prospective studies incorporating tumor-level variables and provider\/center characteristics are needed. Emphasis should remain on timely surgery within multidisciplinary care pathways.<\/jats:p>","DOI":"10.3390\/cancers17183051","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T12:24:25Z","timestamp":1758198265000},"page":"3051","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-Term Survival After Thyroidectomy for Thyroid Cancer: A Propensity-Matched TriNetX Study with Specialty-Stratified Analyses"],"prefix":"10.3390","volume":"17","author":[{"given":"Ci-Wen","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Medical Research, Tungs\u2019 Taichung MetroHarbor Hospital, Taichung 435, Taiwan"},{"name":"Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli 356, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng-Hao","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tungs\u2019 Taichung MetroHarbor Hospital, Taichung 432, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Surgery, National Yang-Ming University Hospital, Yilan 260, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank Cheau-Feng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Chung Shan Medical University Hospital, Taichung 402, Taiwan"},{"name":"School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Tungs\u2019 Taichung MetroHarbor Hospital, Taichung 435, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8991-6394","authenticated-orcid":false,"given":"Yu-Hsiang","family":"Kuan","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan"},{"name":"Department of Pharmacy, Chung Shan Medical University Hospital, Taichung 402, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Chi","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan"},{"name":"Department of Pharmacy, Chung Shan Medical University Hospital, Taichung 402, Taiwan"},{"name":"Master\u2019s Program, Department of Information Management, National Chung Hsing University, Taichung 402, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Kuen","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tungs\u2019 Taichung MetroHarbor Hospital, Taichung 432, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2694-1207","authenticated-orcid":false,"given":"Stella Chin-Shaw","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Tungs\u2019 Taichung MetroHarbor Hospital, Taichung 435, Taiwan"},{"name":"Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402, Taiwan"},{"name":"College of Life Sciences, National Chung Hsing University, Taichung 402, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/SLA.0b013e31814697d9","article-title":"Extent of surgery affects survival for papillary thyroid cancer","volume":"246","author":"Bilimoria","year":"2007","journal-title":"Ann. 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