{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T08:12:28Z","timestamp":1763885548392,"version":"3.45.0"},"reference-count":18,"publisher":"King Faisal Specialist Hospital and Research Centre","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Saudi Med"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Follicular cell-derived thyroid carcinomas (FCTC) are common, with stable mortality rates but significant recurrence risks. Extrathyroidal extension (ETE) affects recurrence risk and staging. The 8th edition of the AJCC\/TNM classification excludes microscopic ETE from upstaging but considers gross ETE a significant factor in older patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>This study examines clinical outcomes and disease-free survival (DFS) in FCTC patients with and without ETE, evaluating the modifying effects of age and tumor size on incomplete response risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN:<\/jats:title>\n                    <jats:p>A single-center retrospective chart review was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING:<\/jats:title>\n                    <jats:p>King Abdulaziz University Hospital<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PATIENTS AND METHODS:<\/jats:title>\n                    <jats:p>Patients aged \u226513 years diagnosed from January 2017 to December 2021 with long-term follow-up (\u226518 months) were included. Medullary and anaplastic thyroid cancers were excluded. Data on demographics, tumor characteristics, risk stratification, and clinical outcomes were collected. Response to therapy was categorized per the 2015 ATA guidelines. Chi-square and Multivariable analysis assessed interactions between age, tumor size, and ETE in predicting incomplete response. Kaplan-Meier curves visualized survival differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MAIN OUTCOME MEASURES:<\/jats:title>\n                    <jats:p>Identifying the interactions between age and tumor size with ETE to predict the risk of incomplete response to therapy among patients with FCTC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SAMPLE SIZE:<\/jats:title>\n                    <jats:p>255 patients. The median follow-up duration was 4 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Patients with ETE were present in (n=38) 15.7% (8% microscopic, 7% gross). Older patients (\u226555 years) with ETE had 26.47-fold higher odds of incomplete response than younger patients. Tumor size independently predicted incomplete response, but its interaction with ETE was not significant. Patients with ETE had a significantly higher incomplete response rate (58% vs. 17%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>Older patients with ETE face a markedly higher risk of incomplete response. Tumor size is an independent risk factor in those patients. Management should be stratified by age, advocating more aggressive management for older patients with ETE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LIMITATIONS:<\/jats:title>\n                    <jats:p>Retrospective, and single-center design.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5144\/0256-4947.2025.414","type":"journal-article","created":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T08:09:23Z","timestamp":1763885363000},"page":"414-420","source":"Crossref","is-referenced-by-count":0,"title":["Age, not tumor size, modifies the association between extrathyroidal extension and long-term outcomes in patients with follicular cell-derived thyroid carcinoma"],"prefix":"10.5144","volume":"45","author":[{"given":"Shaza Ahmed","family":"Samargandy","sequence":"first","affiliation":[{"name":"From the Endocrine Unit, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saad","family":"Samargandy","sequence":"additional","affiliation":[{"name":"From the Endocrine Unit, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5973-2271","authenticated-orcid":true,"given":"Hanan Mohammed","family":"Faruqui","sequence":"additional","affiliation":[{"name":"From the Department of Endocrinology, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asala","family":"Baharoon","sequence":"additional","affiliation":[{"name":"From the Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University Hospital, Jeddah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mazin","family":"Merdad","sequence":"additional","affiliation":[{"name":"From the Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University Hospital, Jeddah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahad Khalaf M.","family":"Alsuwat","sequence":"additional","affiliation":[{"name":"From the Department Department of Endocrinology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3134","reference":[{"issue":"6","key":"e_1_3_2_2_2","first-page":"508","article-title":"Differentiated thyroid cancer: The current state of management","volume":"37","author":"Tuttle RM","year":"2019","unstructured":"Tuttle RM, Haugen BR. Differentiated thyroid cancer: The current state of management. J Clin Oncol. 2019;37(6):508\u201314. https:\/\/doi.org\/10.1200\/JCO.18.02144","journal-title":"J Clin Oncol"},{"issue":"7","key":"e_1_3_2_3_2","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1158\/1055-9965.EPI-21-1440","article-title":"Epidemiology of thyroid cancer","volume":"31","author":"Kitahara CM","year":"2022","unstructured":"Kitahara CM, Schneider AB. Epidemiology of thyroid cancer. Cancer Epidemiol Biomarkers Prev. 2022;31(7):1284\u201397.","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"1","key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1089\/thy.2015.0020","article-title":"2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer","volume":"26","author":"Haugen BR","year":"2016","unstructured":"Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. 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