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Incidental thyroid carcinoma in surgery-treated hyperthyroid patients with Graves’ disease: a systematic review and meta-analysis of cohort studies

Authors Jia Q, Li X, Liu Y, Li L, Kwong JSW, Ren K, Jiang Y, Sun X, Tian H, Li S

Received 5 February 2018

Accepted for publication 22 March 2018

Published 21 May 2018 Volume 2018:10 Pages 1201—1207

DOI https://doi.org/10.2147/CMAR.S164210

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Harikrishna Nakshatri


Qingyi Jia,1,* Xiaodan Li,2,* Ying Liu,3,* Ling Li,4 Joey SW Kwong,4–6 Kaiyun Ren,1 Yong Jiang,7 Xin Sun,4 Haoming Tian,1 Sheyu Li1

1Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China; 2Department of Gastroenterology, West China Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China; 3Department of Pediatrics, West China Second University Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China; 4Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China; 5Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan; 6Department of Clinical Epidemiology and Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan; 7Department of Pathology, West China Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, People’s Republic of China

*These authors contributed equally to this work

Background: The association between Graves’ disease (GD) and thyroid carcinoma remains controversial. This study aimed to investigate incidental thyroid carcinoma (ITC) in surgery-treated hyperthyroid patients with and without GD.
Materials and methods: We searched PubMed and EMBASE for cohort studies investigating ITC in surgery-treated hyperthyroid patients without prediagnosed thyroid carcinoma in accordance with the Meta-Analysis of Observational Studies in Epidemiology guidelines. The last search was updated to January 23, 2018. All statistical tests were performed using Review Manager 5.3 and STATA version 12.0.
Results: Eleven cohort studies involving 10,743 GD and 3,336 non-GD patients were included. The pooled prevalence of ITC was 7.0% (95% confidence interval [CI] 4.5–9.6), and was comparable in surgery-treated GD and non-GD hyperthyroid patients (GD vs non-GD: pooled odds ratio [OR], 1.0; 95% CI: 0.68–1.46; P=0.98). In the subgroup analysis, toxic adenoma and toxic nodular goiter showed no difference when comparing with GD (pooled OR, 0.53; 95% CI: 0.21–1.36; P=0.18 and pooled OR, 1.01; 95% CI: 0.65–1.57; P=0.95, respectively).
Conclusion: Our study demonstrated that GD was not associated with increased risk of ITC in surgery-treated hyperthyroid patients.

Keywords: Graves’ disease, hyperthyroidism, autoimmune thyroid disease, incidental thyroid carcinoma, meta-analysis

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