Thyroid最新文献

{"title":"<i>Corrigendum to:</i> A Phase 2 Study of Encorafenib in Combination with Binimetinib in Patients with Metastatic <i>BRAF</i>-Mutated Thyroid Cancer in Japan.","authors":"","doi":"10.1177/10507256251384793","DOIUrl":"https://doi.org/10.1177/10507256251384793","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of Clinical Outcomes for Total Thyroidectomy/Lobectomy and Isthmusectomy in Patients with Isthmic Papillary Thyroid Carcinoma.","authors":"Seungho Lee, Su-Jin Kim, June Young Choi, Nanhee Park, Jayoun Kim, Yoon Kong, Hye Lim Bae, Ja Kyung Lee, Woochul Kim, Hyeong Won Yu, Young Jun Chai, Kyu Eun Lee","doi":"10.1177/10507256251382600","DOIUrl":"https://doi.org/10.1177/10507256251382600","url":null,"abstract":"<p><p><b><i>Background:</i></b> The optimal surgical extent for isthmus-confined papillary thyroid carcinoma (PTC) remains unclear. We aimed to evaluate the clinicopathological characteristics, surgical complications, and recurrence rates based on the extent of resection. <b><i>Methods:</i></b> This retrospective cohort study included 345 patients who underwent thyroidectomy for solitary isthmus-confined PTC at two affiliated tertiary centers from 2013 to 2022. Patients were excluded if they had multifocal PTC with lobar involvement, large tumors (>4 cm), suspected extrathyroidal extension (ETE), clinically positive lymph nodes (LNs), or aggressive histological subtypes. Clinicopathological features, surgical complication rates, and recurrence rates were compared among the total thyroidectomy (TT), lobectomy (L), and isthmusectomy (I) groups. This retrospective cohort study used propensity score matching (PSM), resulting in two groups of 85 patients: TT/L and I. <b><i>Results:</i></b> Among the 345 included patients, 89 underwent TT, 30 underwent L, and 226 underwent I. After PSM, 170 patients were analyzed. The mean age was 48.2 years, and the mean tumor size was 0.8 cm. Microcarcinoma accounted for 71.8% of cases. The rates of ETE (65.3%), multifocality (9.4%), <i>BRAF</i> mutation (75.3%), and Hashimoto's thyroiditis (19.4%) were observed without significant differences between the TT/L and I groups. Risk stratification for central LN metastasis showed no significant difference (high-risk: 21.2% vs. 27.1%, <i>p</i> = 0.353). No recurrence or distant metastasis was observed in either group during a median follow-up of 4.3 years. Median follow-up was longer in the TT/L group (6.1 years [interquartile range (IQR): 4.0-8.5] vs. 3.6 years [IQR: 2.1-4.9], <i>p</i> < 0.001). Major complications were more frequent in TT/L group: transient/permanent hypocalcemia (14.1%/1.2% vs. 0%/0%) and transient vocal cord palsy (3.5% vs. 0%). Levothyroxine dependency was significantly higher in the TT/L group in terms of usage (90.6% vs. 34.1%, <i>p</i> < 0.001), average administered dose (85.5 ± 45.1 µg vs. 21.9 ± 33.2 µg, <i>p</i> < 0.001), and duration (5.2 ± 3.1 years vs. 0.9 ± 1.3 years, <i>p</i> < 0.001). Newly noted thyroid lesions occurred more frequently in the I group (1.3% vs. 10.6%, <i>p</i> = 0.039). <b><i>Conclusions:</i></b> Isthmusectomy may be considered for carefully selected patients with isthmus-confined PTC. Validation in long-term prospective studies is warranted.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Corrigendum to:</i> Clinical Outcomes of Congenital Hypothyroidism Due to <i>DUOX2</i> Biallelic Mutations after Levothyroxine Withdrawal.","authors":"","doi":"10.1177/10507256251384934","DOIUrl":"https://doi.org/10.1177/10507256251384934","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Pediatric Graves' Disease in the United States: An Epidemiological Analysis of 2007-2022 Outpatient Insurance Claims.","authors":"Srinidhi Polkampally, Akash S Halagur, Allen Green, Eric Wei, Jason Qian, Julia Donner, Hilary Seeley, Kara Meister","doi":"10.1177/10507256251382559","DOIUrl":"https://doi.org/10.1177/10507256251382559","url":null,"abstract":"<p><p><b><i>Background:</i></b> Graves' disease is the leading cause of hyperthyroidism in children and adolescents, with recent studies indicating a rising incidence. Epidemiological data on trends and determinants influencing this rise remain limited. This study aims to assess the trends in incidence of pediatric Graves' disease in the United States and stratify incidence patterns based on patient sex, age, geographic region, urban vs. rural setting, and insurance plan type. <b><i>Methods:</i></b> This retrospective cohort study utilized the Merative™ Marketscan® outpatient insurance claims database from 2007 to 2022. Pediatric patients diagnosed with Graves' disease were identified using International Classification of Diseases (ICD)-9 and ICD-10 codes. Annual incidence rates were analyzed over the study period to detect temporal trends. Incidence rates were further stratified by demographic variables including sex, age, geographic region, community setting (urban vs. rural), and insurance plan. Statistical methods included chi-square, ANOVA, and linear regression models to identify significant trends and differences across subgroups. <b><i>Results:</i></b> 3377 total new diagnoses of pediatric Graves' disease were identified during the 16-year study period. The average annual incidence rate was 3.33 per 100,000 (SD = 0.33), with an annual increase of 0.042 per 100,000 (<i>p</i> = 0.39). Marked differences in average annual incidence rates were observed across sex and age group; female patients exhibited greater average annual incidence rate (5.04 per 100,000) compared with male patients (1.67 per 100,000). Adolescents, patients 13-17 years of age, had the highest average annual incidence rate (5.72 per 100,000) compared with other age groups. On multivariable regression analysis, female patients had a significant increase in annual incidence by 1.69 cases per 100,000 compared with male patients [CI: 0.82-2.56]. Adolescents also saw a significant increase in adjusted annual incidence by 4.92 cases per 100,000 compared with the other age groups [CI: 3.80-6.04]. No significant change in annual incidence rate was observed across insurance plan, geographic region, or rural status. <b><i>Conclusions:</i></b> This study quantifies and delineates trends in pediatric Graves' disease incidence in the United States. The greatest average incidence rate was observed among female and adolescent patients. This study underscores the importance of monitoring Graves' disease trends to facilitate early disease detection and management. Further research is needed to elucidate the genetic and environmental factors underlying these epidemiological trends.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Congenital Hypothyroidism Due to <i>DUOX2</i> Biallelic Mutations after Levothyroxine Withdrawal.","authors":"Feng Sun, Jia-Ping Wan, Na-Na Zhang, Jiayida Nulali, Ya Fang, Hai-Yang Zhang, Chen-Yang Wu, Feng-Yao Wu, Qian-Yue Zhang, Rui-Meng Yang, Rui Li, Lu Li, Bing Han, Xue-Song Li, Feng Cheng, Wen-Hua Du, Shuang-Xia Zhao, Huai-Dong Song","doi":"10.1177/10507256251372195","DOIUrl":"10.1177/10507256251372195","url":null,"abstract":"<p><p><b><i>Background:</i></b> <i>DUOX2</i> is a major cause of congenital hypothyroidism (CH) in Chinese patients, but clinical outcomes for those with biallelic <i>DUOX2</i> mutations remain unclear. This study aimed to describe the clinical manifestations of CH due to <i>DUOX2</i> defect. <b><i>Methods:</i></b> One hundred eighty-one patients with primary CH were recruited initially and were subjected to genetic screening. Patients with <i>DUOX2</i> biallelic mutations were chosen. After 3 years of age, 28 patients underwent a prospective clinical reevaluation after levothyroxine (LT4) withdrawal. Subsequent periodic evaluation of thyroid function was executed to evaluate the necessity of LT4 retreatment. The medical histories of all patients before the age of three years were collected and analyzed. DUOX2 residual enzymatic activity was also calculated relative to clinical outcomes. <b><i>Results:</i></b> Twenty-eight patients who were reevaluated were divided into three groups: patients with permanent CH (PCH; 7/28 [25%]), patients with transient CH (TCH; 6/28 [21.4%]), and patients with hyperthyrotropinemia (15/28 [53.6%]). The median duration of follow-up was 17.5 months (interquartile range: 8.5, 29.25). The correlation between DUOX2 residual enzymatic activity and the clinical outcome of patients with CH with <i>DUOX2</i> biallelic mutations was not clear in this study. No significant differences in laboratory findings at diagnosis were observed among the three groups. LT4 dose decreased with age in TCH but remained stable in PCH. Doses at ages 2, 3, and pre-withdrawal were significantly higher in PCH versus TCH (<i>p</i> = 0.027; <i>p</i> = 0.003; <i>p</i> = 0.025). After LT4 withdrawal, serum thyroglobulin levels and thyroid size increased in most patients (especially hyperthyrotropinemia group) and often persisted for months. Moreover, thyrotropin levels normalized in 44.4% of patients with hyperthyrotropinemia after more than one year off LT4. <b><i>Conclusions:</i></b> Some patients with CH and <i>DUOX2</i> biallelic mutations may have TCH or hyperthyrotropinemia. These patients should undergo long-term follow-up to prevent excessive compensatory thyroid hyperplasia.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Factors in Thyroid Cancer Patients With Brain Metastases: A Systematic Review and Meta-Analysis.","authors":"Hamza A Salim, Ahmed Msherghi, Kim Learned, Mark Zafereo, Jennifer Wang, Samir A Dagher, Ceylan Altintas Taslicay, Richard Dagher, Sahar Alizada, Mimi I Hu, Maria E Cabanillas, Naifa Busaidy, Sarah Hamidi, Hussein Tawbi, Jing Li, F Eymen Ucisik, Max Wintermark","doi":"10.1177/10507256251372639","DOIUrl":"https://doi.org/10.1177/10507256251372639","url":null,"abstract":"<p><p><b><i>Background:</i></b> Brain metastases from thyroid cancer (TC) are rare but signify an advanced stage of the disease with poor survival outcomes. This study aimed to identify prognostic factors associated with brain metastasis-specific survival (BMS) in patients with brain metastases from TC. <b><i>Methods:</i></b> A systematic review and meta-analysis were conducted. Data were extracted from studies retrieved from PubMed, Scopus, Embase, and MEDLINE up to July 18, 2025. A multivariable Cox proportional hazards model was used to estimate hazard ratios (HRs) for potential prognostic factors. <b><i>Results:</i></b> A total of 24 studies, including 301 patients with brain metastases from TC, were included. BMS was 18 months (confidence interval [CI], 1.07 to 3.56). Key prognostic factors associated with decreased BMS included anaplastic thyroid carcinoma (HR, 3.3; CI, 1.06 to 10.3; <i>p</i> = 0.04), poorly differentiated thyroid carcinoma (HR, 1.95; CI, 1.07 to 3.56; <i>p</i> = 0.03), poor performance status (Eastern Cooperative Oncology Group >1) (HR, 2.62; CI, 1.69 to 4.05; <i>p</i> < 0.001), multiple brain metastases (HR, 1.89; CI, 1.24 to 2.89; <i>p</i> = 0.004), and the presence of distant metastases (HR, 1.97; CI, 1.13 to 3.44; <i>p</i> = 0.018). Neither the size nor the anatomical location of brain metastases was significantly associated with BMS. <b><i>Conclusions:</i></b> Brain metastases from TC are associated with poor survival, with key prognostic factors including aggressive tumor subtypes, poor performance status, multiple brain metastases, and the presence of extracranial metastases, particularly in the lungs. These findings highlight the need for a multidisciplinary approach and the importance of systemic disease control in improving outcomes for this challenging patient population.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Prognostic Differences Exist Among High-Risk <i>RET</i> Mutations? A Comparison of Outcomes Between the <i>RET</i> C634R and Other C634 Mutations in Hereditary Medullary Thyroid Carcinoma.","authors":"Jie Zhang, Luciana Audi Castroneves, Susan C Lindsey, Rulai Han, Ziyuan Liu, Yue Li, Jing Xie, Wei Zhou, Qi Song, Cleber P Camacho, Yu Zhao, Xiaoyan Xie, Yulin Zhou, Jiqi Yan, Guang Ning, Weiqing Wang, Rui M B Maciel, Ana O Hoff, Lei Ye","doi":"10.1177/10507256251372196","DOIUrl":"https://doi.org/10.1177/10507256251372196","url":null,"abstract":"<p><p><b><i>Background:</i></b> The American Thyroid Association has stratified <i>RET</i> C634 mutations as high risk. The association between <i>RET</i> C634R mutation and a more aggressive medullary thyroid carcinoma (MTC) behavior compared with other C634 mutations remains inconclusive, possibly due to the lack of large cohorts and long-term outcome data. This study aimed to evaluate the aggressiveness and long-term outcomes of hereditary MTC in patients with different <i>RET</i> codon 634 mutations. <b><i>Methods:</i></b> This study is an international, multicenter, retrospective cohort study. Data from patients with hereditary MTC carrying <i>RET</i> codon 634 mutations treated at three tertiary medical centers were retrospectively analyzed. Clinicopathological features and long-term outcomes were compared between patients with the C634R and those with other C634 mutations (C634F/G/S/W/Y). <b><i>Results:</i></b> The study cohort included 317 patients (C634R: 133; C634F/G/S/W/Y: 184) from 137 families with a median follow-up of 10.6 years (4.9-16.6 years). Patients with the C634R mutation were slightly younger at the time of initial surgery (27.8 ± 12.1 vs. 31.3 ± 14.9, <i>p</i> = 0.025). Meanwhile, the C634R group showed larger primary tumors (1.9 ± 1.2 vs. 1.5 ± 1.1, <i>p</i> = 0.006). Kaplan-Meier analysis revealed significantly higher cumulative rates and earlier occurrence of lymph node metastases (<i>p</i> = 0.0003) and extrathyroidal extension (ETE; <i>p</i> < 0.0001) in the C634R group. The C634R mutation was significantly associated with distant metastases (hazard ratio [HR]: 2.545 [confidence interval (CI) 1.134-5.713]; <i>p</i> = 0.024). Moreover, multivariable analysis identified <i>RET</i> C634R genotype (HR: 6.488 [CI 1.364-30.862]; <i>p</i> = 0.019), increasing age (HR: 1.082 [CI 1.023-1.144]; <i>p</i> = 0.006), and ETE (HR: 9.695 [CI 2.344-40.105]; <i>p</i> = 0.002) to be significantly associated with worse disease-specific survival. <b><i>Conclusions:</i></b> Prognosis varied in hereditary MTC patients with <i>RET</i> C634 mutations. Our data highlight that the <i>RET</i> C634R mutation was associated with greater tumor aggressiveness in MTC and a poorer disease-specific survival.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting B7-H3 in Cancer-Associated Fibroblasts Using Nanosystems Suppresses Anaplastic Thyroid Carcinoma Progression.","authors":"Tong Chen, Xudong Li, Dongken Hong, Lichen Yin, Chen Fang, Xinjian Chen, Zhixue Yang, Peifeng Zhao, Liang Hu, Zhanqing Wang, Lei Cao, Qi Ma","doi":"10.1177/10507256251372644","DOIUrl":"https://doi.org/10.1177/10507256251372644","url":null,"abstract":"<p><p><b><i>Background:</i></b> Anaplastic thyroid carcinoma (ATC) represents a rare yet highly malignant histotype of thyroid cancer. Cancer-associated fibroblasts (CAFs) play a pivotal role in tumor cell invasion, migration, and angiogenesis and present a potential target for cancer treatment. We aimed to investigate the effects of modulating specific subsets of CAFs on the proliferation, invasion, and migration of ATC. <b><i>Methods:</i></b> We developed nanosystems, platelet-derived growth factor receptor (PDGFR-β) targeted-polypeptide-modified poly (β-amino ester) (pBAE) (T-pBAE)/si<i>B7-H3</i> nanoparticles (NPs), targeting PDGFR-β+ CAFs and featuring B7-H3 knockdown. We evaluated both the targeting efficacy and gene silencing performance of T-pBAE/si<i>B7-H3</i> NPs, as well as the functional contribution of B7-H3 to CAFs-driven ATC progression. <b><i>Results:</i></b> T-pBAE/si<i>B7-H3</i> NPs were efficiently internalized by CAFs, achieving targeted knockdown of B7-H3 expression. Silencing B7-H3 significantly suppressed the expression of cell division cycle 27 and other cell cycle-related genes, thereby inhibiting CAFs' proliferation. Consequently, CAFs-secreted cytokines (e.g., CCL1 and CCL4) were altered. Through modulation of cytokine receptor activation on ATC cells, this process reduced ATC cell proliferation, invasion, and migration. In mice ATC subcutaneous tumor models, local injection of T-pBAE/si<i>B7-H3</i> NPs reduced tumor volume. Moreover, the expression of invasive proliferation-related markers (PDGFR-β, Ki-67, CD31), immune evasion-related marker CD163, and chemoresistance-related marker ATP-binding cassette subfamily G member 2 was remarkably downregulated in tumor tissues. <b><i>Conclusion:</i></b> This study demonstrates that PDGFR-β polypeptide-modified pBAE could successfully deliver B7-H3 siRNA to CAFs. After knockdown of B7-H3 within CAFs, ATC proliferation, invasion, and migration were inhibited. Overall, our findings revealed that B7-H3 can be a promising therapeutic target for ATC.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunotherapy in Initial Treatment of Anaplastic Thyroid Cancer: Evaluation of Overall Survival in a National Cancer Database Study.","authors":"Shikha Kini, Vedat Yildiz, Darrion Mitchell, Emile Gogineni, John Grecula, David Konieczkowski, Simeng Zhu, Sung Jun Ma, Priyanka Bhateja, Matthew Old, Nolan Seim, Dukagjin M Blakaj, Dipen Patel, Vineeth Sukrithan, Bhavana Konda, Sujith Baliga","doi":"10.1177/10507256251372191","DOIUrl":"https://doi.org/10.1177/10507256251372191","url":null,"abstract":"<p><p><b><i>Background:</i></b> Anaplastic thyroid cancer (ATC) is an aggressive malignancy with a median survival of six months. While immunotherapy (IT) has improved outcomes in other solid tumors, its role in ATC remains unclear. This study evaluated whether receipt of IT was associated with improved overall survival (OS) in the initial treatment of patients with newly diagnosed ATC. <b><i>Methods:</i></b> We performed a retrospective study of patients with metastatic and nonmetastatic ATC from the National Cancer Database (2008-2020) treated with surgery, radiation, chemotherapy, or a combination. Patient outcomes were stratified between those who received IT at any point in their treatment compared with those who did not. The primary outcome was OS, compared between cohorts receiving IT and those who did not. Survival analyses were performed using Kaplan-Meier estimates, long-rank tests, and multivariable models. <b><i>Results:</i></b> Among 3318 patients with ATC, 87 (2.6%) received IT. Rates of surgical resection (46%) and radiation therapy (64% vs. 57%, <i>p</i> = 0.133) were similar across groups. IT recipients were younger (mean = 66.7 vs. 70.2 years, <i>p</i> = 0.005), more often diagnosed in recent years (2017-2019 vs. 2008-2016, <i>p</i> = 0.0001), and more frequently received chemotherapy (65.5% vs. 46.3%, <i>p</i> = 0.0007). Charlson Comorbidity Index scores were similar (<i>p</i> = 0.551). Median OS was 9.1 months (confidence interval [CI] 7.06-14.9) for those receiving IT versus 3.78 months (CI: 3.52-4.01) for those who did not (<i>p</i> < 0.005). Five-year OS was 18% (CI: 5-36%) with IT versus 9% (CI: 8-10%) without (<i>p</i> < 0.0001). Among 23 patients who received trimodality therapy (surgery, IT, and radiation), 5-year OS was 35% (CI: 16-55%) versus 9% in patients who did not. <b><i>Conclusions:</i></b> IT was associated with prolonged survival in patients with ATC, although confounding factors, such as the retrospective design of the study, lack of detailed IT drug details, and sequencing of therapy, preclude definitive conclusions on its efficacy. The efficacy of IT for ATC as a stand-alone treatment is uncertain. Further studies could indicate which combination of therapies best increases OS in patients with ATC.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Statin Use Following Diagnosis of Graves' Disease Is Associated with a Reduced Risk of Moderate-to-Severe Graves' Orbitopathy in Middle-Aged Adults: Evidence from a Nationwide Taiwanese Cohort.","authors":"Yu-Tsung Chou, Chun-Chieh Lai, Chung-Yi Li, Wei-Chen Shen, Yu-Tung Huang, Yi-Lin Wu, Yi-Hsuan Lin, Deng-Chi Yang, Yi-Ching Yang","doi":"10.1177/10507256251364782","DOIUrl":"10.1177/10507256251364782","url":null,"abstract":"<p><p><b><i>Background:</i></b> Statin use is associated with a reduced risk of Graves' orbitopathy (GO). However, whether the timing of initiating statin treatment after the diagnosis of Graves' disease (GD) affects the association between statin and GO risk remains unclear. This study aims to evaluate the risk of GO based on varying intervals of statin initiation following GD diagnosis. <b><i>Materials and Methods:</i></b> This nationwide, population-based retrospective cohort study used data of all beneficiaries aged >40 years diagnosed with GD from Taiwan's National Health Insurance Research Database (2009-2019). We excluded patients with incomplete data, follow-up <6 months, with a diagnosis of GO, or on medication for hyperlipidemia before GD diagnosis. We performed 1:4 matching based on age, sex, and the duration between GD diagnosis and the index day for statin users and nonusers. GO patients were further classified as having mild or moderate-to-severe GO according to the type of treatment received. <b><i>Results:</i></b> A total of 47,424 patients were categorized into Group A (<1 year, 4649 statin users; 18,584 nonusers), Group B (1-2 years, 3060 statin users; 12,349 nonusers), and Group C (2-3 years, 1752 statin users; 7030 nonusers) by the duration between GD diagnosis and the index date. Cox regression showed that statin users in Group A had a significantly lower risk of total GO (adjusted hazard ratio [HR]: 0.66, confidence interval [CI]: 0.47-0.94, <i>p</i> = 0.023) and moderate-to-severe GO (adjusted HR: 0.39, CI: 0.19-0.80, <i>p</i> = 0.010), but not mild GO (adjusted HR: 0.84, CI: 0.56-1.25, <i>p</i> = 0.385) than nonusers. However, no significant associations were found in Groups B and C. The risk of GO was not statistically different among users of various types or intensities of statins in any group. <b><i>Conclusion:</i></b> Initiating statin treatment within one year after being diagnosed with GD was associated with 34% and 61% reduction in total and moderate-to-severe GO risk, respectively. For patients whose treatment was initiated more than one year after GD was diagnosed, statin use was not related to the risk of total, mild, and moderate-to-severe GO. These findings suggest that the timing of statin initiation may influence the risk of GO, which warrants further confirmation through prospective studies.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"1052-1062"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}