J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

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Original Article

Volume 15, Number 5, December 2025, pages 202-209

Thyroid Cancer in Thyrotoxic Patients: Clinicopathological Features and Outcomes: A Propensity Score Analysis

↓ **Table 1.** Comparison of Clinicopathological Features Between Patients With and Without Thyrotoxicosis in the Complete Cohort (N = 426)
Variable	Thyrotoxic (n = 11)	Non-thyrotoxic (n = 415)	P value
SD: standard deviation; NIFTP: noninvasive follicular thyroid neoplasm with papillary-like nuclear features.
Age at diagnosis (years), mean ± SD	39.9 ± 9.8	41.9 ± 13.4	0.620
Sex
Male	2 (18.2%)	107 (25.8%)	0.569
Female	9 (81.8%)	308 (74.2%)
Pathology
Papillary	10 (90.9%)	372 (89.6%)	0.219
Follicular	0	26 (6.3%)
Poorly differentiated	0	7 (1.7%)
Hurthle cell cancer	0	5 (1.2%)
NIFTP	1 (9.1%)	5 (1.2%)
Size of largest focus (cm), mean ± SD	1.7 ± 1.7	2.7 ± 2.5	0.191
Lymph node metastasis
Present	1 (9.1%)	165 (39.8%)	0.040
Absent	10 (90.9%)	250 (60.2%)
Distant metastasis
Present	0	24 (5.8%)	0.411
Absent	11 (100%)	390 (94.2%)
Stage at diagnosis
1	11 (100%)	371 (89.4%)	0.729
2	0	26 (6.3%)
3	0	6 (1.4%)
4	0	12 (2.9%)
Vascular invasion
None	10 (90.9%)	270 (70.9%)	0.703
Present	1 (9.1%)	90 (23.6%)
Margin involvement
Present	2 (18.2%)	86 (22.9%)	0.711
Absent	9 (81.8%)	289 (77.1%)
Variants of the papillary cancers
Classical	2 (18.2%)	185 (55.9%)	0.004
Follicular	2 (18.2%)	68 (20.5%)
Papillary microcarcinoma	6 (54.5%)	57 (17.2%)
Warthin-like	1 (9.1%)	1 (0.3%)
Hobnail	0	1 (0.3%)
Solid	0	2 (0.6%)
Columnar	0	1 (0.3%)
Diffuse sclerosing	0	5 (1.5%)
Oncocytic	0	1 (0.3%)
Tall cell variant	0	9 (0.9%)
Cribriform-morular	0	1 (0.3%)
Multifocality
Present	5 (45.5%)	191 (48.5%)	0.843
Absent	6 (54.5%)	203 (51.5%)

↓ Table 1. Comparison of Clinicopathological Features Between Patients With and Without Thyrotoxicosis in the Complete Cohort (N = 426)

Variable

Thyrotoxic (n = 11)

Non-thyrotoxic (n = 415)

P value

SD: standard deviation; NIFTP: noninvasive follicular thyroid neoplasm with papillary-like nuclear features.

Age at diagnosis (years), mean ± SD

39.9 ± 9.8

41.9 ± 13.4

0.620

Sex

Male

2 (18.2%)

107 (25.8%)

0.569

Female

9 (81.8%)

308 (74.2%)

Pathology

Papillary

10 (90.9%)

372 (89.6%)

0.219

Follicular

26 (6.3%)

Poorly differentiated

7 (1.7%)

Hurthle cell cancer

5 (1.2%)

NIFTP

1 (9.1%)

5 (1.2%)

Size of largest focus (cm), mean ± SD

1.7 ± 1.7

2.7 ± 2.5

0.191

Lymph node metastasis

Present

1 (9.1%)

165 (39.8%)

0.040

Absent

10 (90.9%)

250 (60.2%)

Distant metastasis

Present

24 (5.8%)

0.411

Absent

11 (100%)

390 (94.2%)

Stage at diagnosis

11 (100%)

371 (89.4%)

0.729

26 (6.3%)

6 (1.4%)

12 (2.9%)

Vascular invasion

None

10 (90.9%)

270 (70.9%)

0.703

Present

1 (9.1%)

90 (23.6%)

Margin involvement

Present

2 (18.2%)

86 (22.9%)

0.711

Absent

9 (81.8%)

289 (77.1%)

Variants of the papillary cancers

Classical

2 (18.2%)

185 (55.9%)

0.004

Follicular

2 (18.2%)

68 (20.5%)

Papillary microcarcinoma

6 (54.5%)

57 (17.2%)

Warthin-like

1 (9.1%)

1 (0.3%)

Hobnail

1 (0.3%)

Solid

2 (0.6%)

Columnar

1 (0.3%)

Diffuse sclerosing

5 (1.5%)

Oncocytic

1 (0.3%)

Tall cell variant

9 (0.9%)

Cribriform-morular

1 (0.3%)

Multifocality

Present

5 (45.5%)

191 (48.5%)

0.843

Absent

6 (54.5%)

203 (51.5%)

↓ **Table 2.** Comparison of Risk Assessment and 1-Year Outcome Between Patients With and Without Thyrotoxicosis in the Complete Cohort (N = 426)
Variable	Thyrotoxic (n = 11)	Non-thyrotoxic (n = 415)	P value
Initial risk stratification
Low	7 (63.6%)	124 (46.4%)	0.466
Intermediate	3 (27.3%)	85 (31.8%)
High	1 (9.1%)	58 (21.7%)
Outcome at 1 year
Excellent response	6 (54.5%)	184 (65.5%)	0.459
In-determined response	3 (27.3%)	41 (14.6%)
Biochemically incomplete	0	23 (8.2%)
Structurally incomplete	2 (18.2%)	33 (11.7%)

↓ Table 2. Comparison of Risk Assessment and 1-Year Outcome Between Patients With and Without Thyrotoxicosis in the Complete Cohort (N = 426)

Variable

Thyrotoxic (n = 11)

Non-thyrotoxic (n = 415)

P value

Initial risk stratification

Low

7 (63.6%)

124 (46.4%)

0.466

Intermediate

3 (27.3%)

85 (31.8%)

High

1 (9.1%)

58 (21.7%)

Outcome at 1 year

Excellent response

6 (54.5%)

184 (65.5%)

0.459

In-determined response

3 (27.3%)

41 (14.6%)

Biochemically incomplete

23 (8.2%)

Structurally incomplete

2 (18.2%)

33 (11.7%)

↓ **Table 3.** Comparison of Clinicopathological Features Between Patients With and Without Thyrotoxicosis of the Cohort After Propensity Score Matching (N = 55)
Variable	Thyrotoxic (n = 11)	Non-thyrotoxic (n = 44)	P value
SD: standard deviation; NIFTP: noninvasive follicular thyroid neoplasm with papillary-like nuclear features.
Age at diagnosis (years), mean ± SD	39.9 ± 9.8	40.0 ± 10.3	0.968
Sex
Male	2 (18.2%)	8 (18.2%)	1.00
Female	9 (81.8%)	36 (81.8%)
Pathology
Papillary	10 (90.9%)	40 (90.9%)	1.00
Follicular	0	0
Poorly differentiated	0	0
Hurthle cell cancer	0	0
NIFTP	1 (9.1%)	4 (9.1%)
Size of largest focus (cm), mean ± SD	1.7 ± 1.7	1.8 ± 1.0	0.696
Lymph node metastasis
Present	1 (9.1%)	15 (34.1%)	0.102
Absent	10 (90.9%)	29 (65.9%)
Distant metastasis
Present	0	0	-
Absent	11 (100%)	44 (100%)
Stage at diagnosis
1	11 (100%)	43 (97.7%)	0.614
2	0	1 (2.3%)
3	0	0
4	0	0
Vascular invasion
None	10 (90.9%)	35 (79.5%)	0.382
Present	1 (9.1%)	9 (20.5%)
Margin involvement
Present	2 (18.2%)	12 (27.3%)	0.536
Absent	9 (81.8%)	32 (72.7%)
Variants of the papillary cancers
Classical	2 (18.2%)	21 (47.8%)	0.035
Follicular	2 (18.2%)	12 (27.3%)
Papillary microcarcinoma	6 (54.5%)	11 (25%)
Warthin-like	1 (9.1%)	0
Hobnail	0	0
Solid	0	0
Columnar	0	0
Diffuse sclerosing	0	0
Oncocytic	0	0
Tall cell variant	0	0
Cribriform-morular	0	0
Multifocality
Present	5 (45.5%)	18 (40.9%)	0.785
Absent	6 (54.5%)	26 (59.1%)

↓ Table 3. Comparison of Clinicopathological Features Between Patients With and Without Thyrotoxicosis of the Cohort After Propensity Score Matching (N = 55)

Variable

Thyrotoxic (n = 11)

Non-thyrotoxic (n = 44)

P value

SD: standard deviation; NIFTP: noninvasive follicular thyroid neoplasm with papillary-like nuclear features.

Age at diagnosis (years), mean ± SD

39.9 ± 9.8

40.0 ± 10.3

0.968

Sex

Male

2 (18.2%)

8 (18.2%)

1.00

Female

9 (81.8%)

36 (81.8%)

Pathology

Papillary

10 (90.9%)

40 (90.9%)

1.00

Follicular

Poorly differentiated

Hurthle cell cancer

NIFTP

1 (9.1%)

4 (9.1%)

Size of largest focus (cm), mean ± SD

1.7 ± 1.7

1.8 ± 1.0

0.696

Lymph node metastasis

Present

1 (9.1%)

15 (34.1%)

0.102

Absent

10 (90.9%)

29 (65.9%)

Distant metastasis

Present

Absent

11 (100%)

44 (100%)

Stage at diagnosis

11 (100%)

43 (97.7%)

0.614

1 (2.3%)

Vascular invasion

None

10 (90.9%)

35 (79.5%)

0.382

Present

1 (9.1%)

9 (20.5%)

Margin involvement

Present

2 (18.2%)

12 (27.3%)

0.536

Absent

9 (81.8%)

32 (72.7%)

Variants of the papillary cancers

Classical

2 (18.2%)

21 (47.8%)

0.035

Follicular

2 (18.2%)

12 (27.3%)

Papillary microcarcinoma

6 (54.5%)

11 (25%)

Warthin-like

1 (9.1%)

Hobnail

Solid

Columnar

Diffuse sclerosing

Oncocytic

Tall cell variant

Cribriform-morular

Multifocality

Present

5 (45.5%)

18 (40.9%)

0.785

Absent

6 (54.5%)

26 (59.1%)

↓ **Table 4.** Comparison of Risk Assessment and 1-Year Outcome Between Patients With and Without Thyrotoxicosis in the Cohort After Propensity Score Matching (N = 55)
Variable	Thyrotoxic (n = 11)	Non-thyrotoxic (n = 44)	P value
Initial risk stratification
Low	7 (63.6%)	28 (63.6%)	0.122
Intermediate	3 (27.3%)	16 (36.4%)
High	1 (9.1%)	0
Outcome at 1 year
Excellent response	6 (54.5%)	30 (68.2%)	0.290
In-determined response	3 (27.3%)	6 (13.6%)
Biochemically incomplete	0	5 (11.4%)
Structurally incomplete	2 (18.2%)	3 (6.8%)

↓ Table 4. Comparison of Risk Assessment and 1-Year Outcome Between Patients With and Without Thyrotoxicosis in the Cohort After Propensity Score Matching (N = 55)

Variable

Thyrotoxic (n = 11)

Non-thyrotoxic (n = 44)

P value

Initial risk stratification

Low

7 (63.6%)

28 (63.6%)

0.122

Intermediate

3 (27.3%)

16 (36.4%)

High

1 (9.1%)

Outcome at 1 year

Excellent response

6 (54.5%)

30 (68.2%)

0.290

In-determined response

3 (27.3%)

6 (13.6%)

Biochemically incomplete

5 (11.4%)

Structurally incomplete

2 (18.2%)

3 (6.8%)