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Original Article Prognosis of Poorly Differentiated Thyroid Carcinoma: A Systematic Review and Meta-Analysis
Ji Young Kim1orcid , Jae Kyung Myung2, Soyun Kim3, Kyung Tae4, Yun Young Choi1, Soo Jin Lee1orcid

DOI: https://doi.org/10.3803/EnM.2024.1927 [Epub ahead of print]
Published online: June 27, 2024
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1Department of Nuclear Medicine, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, Korea
2Department of Pathology, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, Korea
3Hanyang University College of Medicine, Seoul, Korea
4Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
Corresponding author:  Soo Jin Lee, Tel: +82-2-2290-9259, Fax: +82-2-2290-9260, 
Email: leesoojin@hanyang.ac.kr
Received: 8 January 2024   • Revised: 26 February 2024   • Accepted: 16 April 2024

Background
Poorly differentiated thyroid carcinoma (PDTC) accounts for a small portion of thyroid carcinomas but contributes to a significant proportion of thyroid carcinoma-associated deaths. The clinicopathological prognostic factors and clinical outcomes of PDTC remain unclear. We aimed to evaluate the clinical outcomes of patients with PDTC after curative treatment.
Methods
A comprehensive search was performed up to September 2023. We included studies investigating treatment outcomes in patients with PDTC who underwent initial surgery. The 5-year disease-free survival (DFS) and overall survival (OS) were extracted. In this meta-analysis, the enrolled PDTC histological criteria included 3rd, 4th, and 5th World Health Organization (WHO) and Memorial Sloan Kettering Cancer Center (MSKCC) classification. A random-effects model was used for the pooled proportion analysis. Meta-regression analysis was conducted to evaluate the prognostic factors.
Results
Twenty retrospective studies published between 2007 and 2023, including 1,294 patients, met all inclusion criteria. Studies that diagnosed PDTC based on various histological criteria including 3rd WHO (n=5), 4th WHO (n=12), 5th WHO (n=2), and MSKCC (n=1) were included. Overall, 5-year DFS and 5-year OS were 49.4% (95% confidence interval [CI], 42.3 to 56.4) and 73.8% (95% CI, 66.5 to 79.9), with moderate heterogeneity of 58% and 55%, respectively. In meta-regression analysis, extrathyroidal extension (ETE) was a prognostic factor for OS.
Conclusion
The meta-analysis of DFS and OS in patients with PDTC show the moderate heterogeneity with a variety of histological criteria. ETE appears to have a significant impact on OS, regardless of histological criteria.


Endocrinol Metab : Endocrinology and Metabolism