Comparable Outcomes of Differentiated Thyroid Cancer in Immunocompromised versus Immunocompetent Patients

Background Differentiated thyroid cancer (DTC) is generally a highly treatable malignancy with low mortality and a favorable prognosis. However, the impact of immunodeficiency on DTC outcomes remains poorly understood, with research largely limited to organ transplant recipients. This study aimed to address this gap by comparing the clinical characteristics and outcomes of DTC in immunocompromised patients with a propensity matched cohort of immunocompetent individuals. Methods The study compared adult patients with DTC and pre-existing immunodeficiencies treated at Memorial Sloan-Kettering Cancer Center between 1987 and 2020 to a propensity-matched control group of immunocompetent patients, with a 5:1 comparison ratio. Data on demographics, disease characteristics, and outcomes were analyzed. Results Among 8,534 DTC patients, 130 (1.5%) were immunocompromised. After propensity score matching, 650 immunocompetent patients were included for comparison. Recurrence-free survival did not differ significantly between groups (p = 0.94), with recurrence rates remaining below 10% in both cohorts over 180 months. At 10 years, disease-specific survival was also similar (p = 0.34), with rates of 100% for immunocompromised and 98% for immunocompetent patients. Conclusions DTC has a comparable prognosis in immunocompetent and immunocompromised patients.