Clinical Features and Outcome of the Tall Cell Variant of Papillary Thyroid Carcinoma

Leung, Alex Kwok-Cheung; Chow, Sin‐Ming; Law, Stephen C.K.

doi:10.1097/mlg.0b013e318156f6c3

Cited by 66 publications

(44 citation statements)

References 14 publications

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“…TCV, first described in 1976, accounts for 3-12% of all PTC, and is characterized by a population of cells at least twice as tall as they are wide, comprising 30-70% of total tumor cells (8,(18)(19)(20)(21)(22). TCV has been reported to be larger than classic PTC on average, with higher rates of bilaterality, multifocality, extrathyroidal extension, recurrence, lymph-node/distant metastasis, and decreased survival (12,17,(23)(24)(25)(26)(27)(28)(29)(30).…”

Section: Introductionmentioning

confidence: 99%

Aggressive Variants of Papillary Thyroid Microcarcinoma Are Associated with Extrathyroidal Spread and Lymph-Node Metastases: A Population-Level Analysis

Kuo

Goffredo

Sosa

et al. 2013

Thyroid

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Background: Tall cell variant (TCV) and diffuse sclerosing variant (DSV) of papillary thyroid cancer are aggressive subtypes, for which tumors £ 1 cm have not been exclusively studied. Methods: The SEER database ) was used to compare characteristics of TCV £ 1 cm (mTCV) and DSV £ 1 cm (mDSV) with classic papillary thyroid microcarcinoma (mPTC). Survival was analyzed with the KaplanMeier method and log-rank test, and risk factors for nodal metastases with chi-square analysis and binary logistic regression. Results: There were 97 mTCV, 90 mDSV, and 18,260 mPTC patients. mTCV incidence increased by 79.9% ( p = 0.153) over the study period, while mDSV incidence decreased by 10.3% ( p = 0.315). Compared to classic mPTC, mTCV tended to be larger on average (7.1 mm vs. 5.3 mm, p < 0.001), with higher rates of multifocality (47.2% vs. 34.0% respectively, p = 0.018) and lymph-node examination (63.9% vs. 39.2% respectively, p < 0.001), while in mDSV, nodal metastases were more frequent (57.1% vs. 33.1% respectively, p = 0.007). Both aggressive variants had higher rates of extrathyroidal extension (27.8% mTCV vs. 13.3% mDSV vs. 6.1% mPTC, p < 0.001). Aggressive variants also received radioactive iodine more frequently (39.2% mTCV vs. 40.0% mDSV vs. 29.1% mPTC, p < 0.001). However, they were not statistically more likely to receive thyroidectomy over lobectomy compared to classic mPTC. There were no significant differences in overall and disease-specific survival between the histologies. In mTCV, after adjustment, extrathyroidal extension was independently associated with size > 7 mm (odds ratio (OR) 4.4 [CI 1.5-13.6]) and nodal metastasis with multifocality ) and extrathyroidal extension . No statistically significant predictors of extrathyroidal extension or nodal metastasis in mDSV were observed. Conclusions: Aggressive variants of mPTC tend to exhibit more aggressive pathologic characteristics than classic mPTC, but survival appears to be similar. Treatment with total thyroidectomy and central lymphadenectomy may be warranted if the diagnosis can be made pre-or intraoperatively.

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Section: Introductionmentioning

confidence: 99%

Aggressive Variants of Papillary Thyroid Microcarcinoma Are Associated with Extrathyroidal Spread and Lymph-Node Metastases: A Population-Level Analysis

Kuo

Goffredo

Sosa

et al. 2013

Thyroid

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“…La mayoría son tumores duros, blanco grisáceos, de bordes irregulares y con evidente infi ltración del parénquima del tiroides vecino, con tamaños que varían desde algunos milímetros hasta varios centímetros 29 . En Chile no se ha descrito la incidencia de las variedades de cáncer papilar, el pronóstico descrito en la literatura extranjera para cada una de ellas es contradictorio [3][4][5][6][7][8][9][10] . En esta serie identifi camos que las variedades más frecuentes de CPT son papilar puro y la variedad folicular, constituyendo ambos el 90% de los casos, (objetivo 1 del estudio).…”

Section: Discussionunclassified

“…No encontramos asociación entre las variantes histológicas y recurrencia, ni entre esas variantes y estadio de la enfermedad o, entre las variantes y mortalidad, (objetivo 3). Esta ausencia de asociación a mal pronóstico se puede explicar en nuestra serie, por la baja incidencia de las variantes de CPT que tienen un conocido peor pronóstico como la variedad esclerosante 6,7 y de células altas [8][9][10] . La sobrevida actuarial de 95% al cierre del seguimiento está dentro de lo descrito en publicaciones extranjeras 6,21,30 y locales 22,23 , que señalan sobrevida global, luego de tratamiento asociado de cirugía y Yodo radiactivo (I 131 ), de hasta 95% y sobrevida hasta 100% en estadios I y II.…”

Section: Discussionunclassified

“…Los subtipos con mejor pronóstico corresponden a las formas papilares puras, variedad folicular 3 y encapsulado 4,5 . Los CPT con peor pronóstico corresponden a la variedad esclerosante 6,7 , de células altas [8][9][10] y no encapsulado 9 . Las variedades microcarcinoma y pobremente diferenciada, muestran resultados contradictorios.…”

Section: Factores Pronóstico De Las Variantes De Cáncer Papilar De Tiunclassified

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Factores pronóstico de las variantes de cáncer papilar de tiroides

et al. 2010

Rev Chil Cir

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Association between pathological variants of papillary thyroid cancer and prognosis Background: Papillary thyroid carcinoma had a survival over 90% in stages I , II and III. Treatment failures are observed in advanced tumors, when there is lymph node involvement or when there is vascular invasion. Aim: To assess the prognostic value of pathological variants of papillary thyroid carcinoma. Material and Methods: Review of pathological records of patients with papillary thyroid cancer operated between January 1999 and December 2008 in a regional hospital. The pathological variant of the tumor was revised and classifi ed again as follicular variant, sclerosing, solid, tall cell variant, columnar variant, oncocytic, cribriform, microcarcinoma, insular variant and poorly differentiated. Results: The records of 51 females aged 48 ± 16 years and 12 males aged 42 ± 18 years were identifi ed. Forty patients had a well differentiated carcinoma (63%), 16 had a follicular variant (25%), four had a sclerosing variant and three other types. Capsule involvement was observed in six of 27 stage I, four of nine stage II, 20 of 26 stage III and one of one stage four tumor. Peritumoral lymphatic invasion was observed in 12 of 27 stage I, four of nine stage II, 21 of 26 stage III and one of one stage IV tumor. Lymph node relapse was observed in three patients without and nine patients with capsule involvement (p < 0.01) and in 11 of 38 patients without and 27 of 38 patients with lymphatic invasion (p < 0.01). Two patients in stage III and one in stage IV died. Lethality was 3%. Conclusions: Relapse of papillary carcinoma was associated with capsule involvement and lymphatic invasion. Tumor variants were not associated with relapse or mortality

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“…Послеоперационная стратификация риска рецидива ВДРЩЖ Стадирование послеоперационного риска ВДРЩЖ по классификации AJCC/UICC TNM в настоящий момент не удовлетворяет со-временным требованиям планирования дальней ших лечебных методов и наблюде-ния [97][98][99][100][101][102][103][104][105][106][107][108].…”

Section: лечениеunclassified

2016 Russian clinical practice guidelines for differentiated thyroid cancer diagnosis and treatment

et al. 2017

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В представленных клинических рекомендациях обсуждаются современные подходы к диагностике и лечению дифференцированного рака щитовидной железы у взрослых. Изменения в настоящей редакции Клинических рекомендаций касаются показаний к пункционной биопсии, скринингового определения концентрации кальцитонина, унификации заключений цитологического исследования, новых подходах к послеоперационной динамической стратификации риска рецидива, показаний к супрессивной и заместительной терапии, таргетной терапии йоднегативных форм дифференцированного рака щитовидной железы.

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Clinical Features and Outcome of the Tall Cell Variant of Papillary Thyroid Carcinoma

Cited by 66 publications

References 14 publications

Aggressive Variants of Papillary Thyroid Microcarcinoma Are Associated with Extrathyroidal Spread and Lymph-Node Metastases: A Population-Level Analysis

Aggressive Variants of Papillary Thyroid Microcarcinoma Are Associated with Extrathyroidal Spread and Lymph-Node Metastases: A Population-Level Analysis

Factores pronóstico de las variantes de cáncer papilar de tiroides

2016 Russian clinical practice guidelines for differentiated thyroid cancer diagnosis and treatment

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