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Head and Neck Surgery

(010) Academic Programs Achieve Better Thyroid Cancer Survival, Despite Longer Wait-times

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio

    Presenting Author(s)

  • Jason Tasoulas, MD, DMD

    Post-Doc Research Fellow, Department of Otolaryngology/Head and Neck Surgery
    University of North Carolina at Chapel Hill
    Chapel Hill, North Carolina, United States

    • Co-Author(s)

  • JB

    Jeffrey Blumberg, MD, FACS

    Assistant Professor, Department of Otolaryngology-Head and Neck Surgery
    University of North Carolina at Chapel Hill, USA

  • TS

    Travis P. Schrank, MD, PhD

    Assistant Professor, Department of Otolaryngology-Head and Neck Surgery
    University of North Carolina at Chapel Hill, USA

  • CS

    C. Blake Sullivan, MD

    Assistant Professor, Department of Otolaryngology-Head and Neck Surgery
    University of North Carolina at Chapel Hill, USA

  • WY

    Wendell G. Yarbrough, MD, MMHC , FACS

    Distinguished Professor, Department of Otolaryngology-Head and Neck Surgery
    University of North Carolina at Chapel Hill, USA

  • SS

    Siddharth H. Sheth, DO, MPH

    Assistant Professor, Division of Oncology, Department of Medicine
    University of North Carolina at Chapel Hill, USA

    • Senior Author(s)

  • SS

    Siddharth H. Sheth, DO, MPH

    Assistant Professor, Division of Oncology, Department of Medicine
    University of North Carolina at Chapel Hill, USA

    • Co-Author(s)

  • Trevor Hackman, MD, FACS

    Professor and Division Chief Surgical Oncology, Department of Otolaryngology-Head and Neck Surgery
    University of North Carolina at Chapel Hill
    Chapel Hill, North Carolina, United States

    • Senior Author(s)

  • Trevor Hackman, MD, FACS

    Professor and Division Chief Surgical Oncology, Department of Otolaryngology-Head and Neck Surgery
    University of North Carolina at Chapel Hill
    Chapel Hill, North Carolina, United States

Disclosure(s):
Trevor Hackman, MD, FACS: No relevant relationships to disclose.


Introduction: The association between surgical volume and outcome is well demonstrated in several fields of surgical oncology, resulting in a trend for centralization of cancer care. The objective of the study was to evaluate the impact of treatment facility type in thyroid cancer (TC) care.

Methods: Retrospective cohort analysis of patients with a diagnosis of papillary, follicular, medullary, or anaplastic thyroid cancer from the National Cancer Data Base from 2004-2019. Age, sex, race, income, facility type, TNM stage, histology, and days from diagnosis to definitive surgery data were recorded.

Results: A total of 208,589 TC patients were identified. Between 2004-2019, time from diagnosis to definitive surgery increased from43d to 60d at academic programs and from 38d to 55d at non-academic programs. Compared to 2004-20007, an increased percentage of patients was treated at AP in 2016-2019 (42% vs.47%). After adjusting for epidemiologic and clinicopathologic variables, patients treated at AP had better overall survival (OS) (RR=0.92, 95%CI: 0.90-0.95). The survival benefit persisted across all histologic types: papillary (RR=0.92, 95%CI: 0.89-0.95), follicular (RR=0.90, 95%CI: 0.82-1.00), medullary (RR=0.86, 95%CI: 0.76-0.97) and anaplastic (RR=0.94, 95%CI: 0.90-0.99).

Conclusions: Between 2004 and 2019, time from diagnosis to definitive surgery increased at AP and NAP with AP exhibiting longer wait times. Treatment at academic programs is associated with improved survival, which may be explained by presence of multidisciplinary teams and subspecialists that may be less available at non-academic programs.