The impact of sex disparities on the clinical behavior and prognosis of thyroid cancer
On behalf of all the contributing authors, I would like to express our sincere appreciation of your constructive comments (1). Sex disparity in disease incidence, progression, and prognosis has been observed in a variety of different tumors (2). In general, men have a higher incidence of cancer than women, but the prognosis is reversed (3,4). One remarkable exception is the papillary thyroid cancer, the incidence of papillary thyroid cancer is significantly higher in women than in men (5), and the associated causes of these differences are not fully understood. This study aimed to determine the characteristics of female and male thyroid cancer, and compare their clinical behavior and survival via using the Surveillance, Epidemiology, and End Results (SEER) database. Our study revealed that male patients had larger tumors and higher tumor-node-metastasis (TNM) stage. Moreover, male patients had a prognostic factor for poorer overall survival (OS) and cancer-specific survival (CSS). Additionally, this study also showed that male and female patients had different prognostic risk factors. However, the current article has some problems as described by the authors. We miswrote millimeters as centimeters and are very sorry for our incorrect writing, thank you for your correction. As for patients’ age, the 8th edition of the American Joint Committee on Cancer (AJCC) TNM staging system raised age cutoff value from 45 to 55 years based on multiple population-based studies (6,7), and 55 years as the cutoff value was more robust to achieve better predictability for CSS (8,9). Therefore, we choose 55 years as the cutoff value to validate the prognosis in female and male thyroid patients. Although the 7th TNM staging for all patients in this study, it does not mean that analysis the clinical features and prognosis must be used 45 years as the cutoff value. At last, thanks for your enthusiasm for our article.
Provenance and Peer Review: This article was commissioned by the editorial office, Gland Surgery. The article did not undergo external peer review.
Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-2023-01/coif). The author has no conflicts of interest to declare.
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- Li P, Ding Y, Liu M, et al. Sex disparities in thyroid cancer: a SEER population study. Gland Surg 2021;10:3200-10. [Crossref] [PubMed]
- LeClair K, Bell KJL, Furuya-Kanamori L, et al. Evaluation of Gender Inequity in Thyroid Cancer Diagnosis: Differences by Sex in US Thyroid Cancer Incidence Compared With a Meta-analysis of Subclinical Thyroid Cancer Rates at Autopsy. JAMA Intern Med 2021;181:1351-8. [Crossref] [PubMed]
- Haupt S, Caramia F, Klein SL, et al. Sex disparities matter in cancer development and therapy. Nat Rev Cancer 2021;21:393-407. [Crossref] [PubMed]
- Rubin JB. The spectrum of sex differences in cancer. Trends Cancer 2022;8:303-15. [Crossref] [PubMed]
- Shobab L, Burman KD, Wartofsky L. Sex Differences in Differentiated Thyroid Cancer. Thyroid 2022;32:224-35. [Crossref] [PubMed]
- van Velsen EFS, Stegenga MT, van Kemenade FJ, et al. Comparing the Prognostic Value of the Eighth Edition of the American Joint Committee on Cancer/Tumor Node Metastasis Staging System Between Papillary and Follicular Thyroid Cancer. Thyroid 2018;28:976-81.
- Nixon IJ, Wang LY, Migliacci JC, et al. An International Multi-Institutional Validation of Age 55 Years as a Cutoff for Risk Stratification in the AJCC/UICC Staging System for Well-Differentiated Thyroid Cancer. Thyroid 2016;26:373-80. [Crossref] [PubMed]
- Kim M, Kim YN, Kim WG, et al. Optimal cut-off age in the TNM Staging system of differentiated thyroid cancer: is 55 years better than 45 years? Clin Endocrinol (Oxf) 2017;86:438-43. [Crossref] [PubMed]
- Alzahrani AS, Albalawi L, Mazi S, et al. How Does The AJCC/TNM Staging System Eighth Edition Perform in Thyroid Cancer at A Major Middle Eastern Medical Center? Endocr Pract 2021;27:607-13.