Sex and Mortality Among Patients with Papillary Thyroid Cancer
Liufeng Wu, Zhuo Wang, Shuhuang Lin, Aarti Mathur, Ying Li, Bela Bendlova, Vlasta Kuklikova, Miguel Melo, Tito Teles Jesus, Paula Soares, Carla Colombo, Laura Fugazzola, Norisato Mitsutake, Michiko Matsuse, Ayaka Sako, Ana P. Estrada-Florez, Mabel E. Bohórquez, Luis G. Carvajal-Carmona, Caterina Mian, Federica Vianello, Christine J. O’Neill, Roderick Clifton-Bligh, Agnieszka Czarniecka, Barbara Jarzab, Chan Kwon Jung, Bayu Brahma, Paul W. Ladenson, Young Joo Park, Mingzhao XingImportance
Unlike patient age, which has been a well-established and routinely used primary biological prognostic factor in the risk stratification of papillary thyroid cancer (PTC), the prognostic value of patient sex remains controversial in this common endocrine malignant neoplasm.
Objective
To examine PTC-specific mortality risk of sex with respect to patient age and tumor genetics—specifically the status of
Design, Setting, and Participants
This cohort study was conducted among patients with PTC with an overall median (IQR) follow-up time of 51.0 (26.4-109.1) months after initial treatment at 15 centers in 10 countries between 1979 and 2023. Data analysis was completed in December 2025 and examined aggregately for the association of PTC-specific mortality and patient sex with respect to patient age and
Main Outcome and Measure
Patient deaths specifically caused by PTC.
Results
The study included 4746 patients with PTC (median [IQR] age, 48 [37-59] years; 3612 women [76.1%]). Male patients, compared with female patients, demonstrated a higher overall PTC-specific mortality (3.7% [42 of 1134] vs 1.7% [60 of 3612];
Conclusions and Relevance
This cohort study reconciled previous controversies on the prognostic value of patient sex and establishes male sex as a cardinal mortality risk in PTC in a patient age- and tumor genetic-dependent manner, defining especially male patients aged 45 years and older with dual