Primary Squamous Cell Carcinoma in the Thyroid Gland: A Population-Based Analysis Using the SEER Database

• Published in: World journal of surgery Vol. 43; no. 5; pp. 1249 - 1255
• Main Authors: Yang, Shuwen, Li, Cunfu, Shi, Xiao, Ma, Ben, Xu, Weibo, Jiang, Hongyi, Liu, Wanlin, Ji, Qinghai, Wang, Yu
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 15-05-2019; Springer Nature B.V
• Subjects: Abdominal Surgery; Adult; Aged; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - therapy; Cardiac Surgery; Cohort Studies; Diagnosis; Epidemiology; Female; General Surgery; Geographical locations; Humans; Identification methods; Kaplan-Meier Estimate; Male; Malignancy; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Morphology; Neoplasm Staging; Original Scientific Report; Patients; Prognosis; Radiation; Radiation therapy; Registries; Risk Factors; SEER Program; Squamous cell carcinoma; Surgery; Survival; Thoracic Surgery; Thyroid; Thyroid carcinoma; Thyroid gland; Thyroid Neoplasms - diagnosis; Thyroid Neoplasms - mortality; Thyroid Neoplasms - pathology; Thyroid Neoplasms - therapy; Treatment Outcome; Tumors; United States - epidemiology; Vascular Surgery; Young Adult; United States
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-019-04906-2

Objects
To evaluate prognostic factors and treatment outcomes of primary squamous cell carcinoma in thyroid (PSCCTh) over the past decades using a large national database.
Methods
All patients diagnosed with PSCCTh between 1973 and 2015 were identified with the Surveillance, Epidemiology, and End Results Program (SEER) 18-registry database. Relevant clinical data were collected, and prognostic factors of overall survival (OS) and disease-specific survival (DSS) were analyzed.
Results
This cohort study included 242 patients, accounting for 0.12% of all primary thyroid carcinomas from 1973 to 2015 nationwide. Of the patients with PSCCTh, 75% were older than 60 years at diagnosis. Patient age older than 60 years (HR 2.242, 95% CI 1.367–3.676,
P
 = 0.001) and a tumor size larger than or equal to 50 mm (HR 1.479, 95% CI 1.011–2.165,
P
 = 0.044) were independent negative prognostic factors. The univariate analysis suggested that the morphological subtype (OS,
P
 = 0.033; DSS,
P
 = 0.048), clinical treatment modality (OS,
P
 < 0.0001; DSS,
P
 < 0.0001), and T stage (OS,
P
 = 0.004; DSS,
P
 = 0.001) were important predictive factors for OS and DSS. In contrast, gender, race, year of diagnosis, geographic location, N stage, and M stage were not prognostic factors.
Conclusions
PSCCTh is a rare malignancy with an aggressive nature and poor prognosis. Survival is predicted by the treatment modality, patient age, T stage, tumor size, and morphological subtypes. This study showed that early diagnosis and complete surgical resection plus adjuvant radiation therapy were associated with a better outcome.