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Recent Pregnancy is Not Associated with High-Risk Pathological Features of Well-Differentiated Thyroid Cancer.

Recent Pregnancy is Not Associated with High-Risk Pathological Features of Well-Differentiated Thyroid Cancer.
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Chen AJ, Livhits MJ, Du L, Wu JX, Kuo EJ, Yeh MW, Leung AM,


Chen AJ, Livhits MJ, Du L, Wu JX, Kuo EJ, Yeh MW, Leung AM, (click to view)

Chen AJ, Livhits MJ, Du L, Wu JX, Kuo EJ, Yeh MW, Leung AM,

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Thyroid : official journal of the American Thyroid Association 2017 11 21() doi 10.1089/thy.2017.0496

Abstract
BACKGROUND
Thyroid cancer is commonly diagnosed in the first postpartum year, supporting the theory that high levels of estrogen may stimulate progression of hormone-mediated thyroid cancer. The aim of this study was to assess the effect of recent pregnancy on histopathologic disease characteristics of well-differentiated thyroid cancer (WDTC).

METHODS
Cases of WDTC (1999-2012) were identified from the California Cancer Registry and linked to data from the Office of Statewide Health Planning and Development. Using a matched control design, recently pregnant women (pregnancy up to 5 years before and 9 months after a thyroid cancer diagnosis) were compared with non-pregnant controls matched by age and race/ethnicity. The main outcome measures were histopathologic tumor characteristics (tumor size, extrathyroidal extension, and nodal metastases), disease status at last follow-up, and five-year disease-specific survival.

RESULTS
The study sample of 1,204 women (mean age 30.9±5.5 [SD] years, 46.5% Caucasian and 40.0% Hispanic) included 301 recently pregnant women matched against 903 non-pregnant controls. Comparing recently pregnant vs. non-pregnant women, no significant differences were observed with respect to tumor size (mean 2.2±1.6 vs. 2.3±3.9 cm; p=0.39), extrathyroidal extension (12.0% vs. 14.1%; p=0.46), stage at diagnosis (localized disease: 67.4% vs. 62.8%; regional metastases: 30.1% vs. 33.4%; distant metastases: 2.0% vs. 3.8%; p=0.17), disease status at last follow-up (free of tumor vs. not free of tumor; p=0.48), and five-year disease-specific survival (99.5% vs. 99.5%). In multivariate analyses, after controlling for patient age and ethnicity, recent pregnancy was not a significant predictor of tumor size, extrathyroidal extension, nodal metastases or distant metastases.

CONCLUSIONS
In this cohort, recent pregnancy was not associated with high-risk pathological features of differentiated thyroid cancer. These findings provide reassurance with regards to the concern that pregnancy may act as a potential stimulus for thyroid cancer growth.

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