Follicular cell-derived thyroid carcinomas

Grebe, Stefan K.; Hay, Ian D.

doi:10.1007/978-1-4615-6355-6_6

Cited by 59 publications

(45 citation statements)

References 96 publications

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“…In 1970, a group from the University of Michigan reported that 84 patients with FCDC, who were aged 40 years and older, and were treated with surgery followed by RAI, experienced a significantly lower mortality rate than 32 controls who had surgery alone [21]. However, in this report the extent of disease was not controlled and the socalled control group came from an earlier period (1933)(1934)(1935)(1936)(1937)(1938)(1939)(1940)(1941)(1942)(1943)(1944)(1945)(1946)(1947) marked by less aggressive surgery [3].…”

Section: Origins Early Claims and Later Disclaimers For Remnant Ablcontrasting

confidence: 50%

“…PTC is associated typically with a 20-year cause-specific mortality of only 5%, whereas in most recent studies, the less common follicular thyroid cancer (FTC) and Hurthle cell cancer (HCC) have higher 20-year mortality rates in the 15%-25% range [3]. Radioactive iodine (RAI) was first used to treat metastatic follicular cell-derived cancer (FCDC) in 1940 [1].…”

Section: Introductionmentioning

confidence: 99%

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Selective use of radioactive iodine in the postoperative management of patients with papillary and follicular thyroid carcinoma

Hay

2006

Journal of Surgical Oncology

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Radioiodine remnant ablation (RRA) was developed in the 1960s to "complete a thyroidectomy" in the initial management of papillary and follicular thyroid cancer. By the 1990s, it was claimed that RRA diminished recurrence rates in follicular cell-derived cancer (FCDC) patients and decreased the cause-specific mortality (CSM) in patients more than 40 years old at initial surgery. The international trend for the past decade has been towards routine RRA in most FCDC patients. Clinical guidelines have been produced by many societies, promoting such an aggressive stance. Since 1997, many papers have reported improved outcome in FCDC, when patients were subjected to RRA after bilateral lobar resection. However, during the same time-period, it has been recognized that most FCDC patients are truly at "low-risk" of developing life-threatening recurrences. Accordingly, it has been suggested that rational therapy selection should lead to restricting aggressive therapy to those "high-risk" FCDC patients, more predisposed to CSM. To date, no prospective controlled trials exist. Presently available outcome data is based on single institutional or multicenter retrospective studies. This article summarizes the available relevant reported data, and concludes that a selective use of RRA in the postoperative management of FCDC patients is rational, and should actually be encouraged.

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Section: Origins Early Claims and Later Disclaimers For Remnant Ablcontrasting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

Selective use of radioactive iodine in the postoperative management of patients with papillary and follicular thyroid carcinoma

Hay

2006

Journal of Surgical Oncology

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“…These tumors often present as thyroid nodules or as lymphadenopathy due to metastases (1,2). Papillary thyroid carcinoma is frequently seen in the setting of Hashimoto's thyroiditis and is more frequently multifocal than any other well-characterized type of thyroid carcinoma.…”

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confidence: 99%

Molecular Evidence for the Same Clonal Origin of Multifocal Papillary Thyroid Carcinomas

McCarthy

Wang

Jones

et al. 2006

Clinical Cancer Research

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Purpose: Patients with papillary thyroid carcinoma often have two or more distinct papillary tumors at thyroidectomy. Whether these multifocal papillary lesions are clonally related or whether they arise independently is unknown as previous studies have shown conflicting results. Molecular analysis of microsatellite alterations and X-chromosome inactivation status in separate tumors from the same patient can be used to define the genetic relationships among the multiple coexisting tumors. Experimental Design: We examined 64 separate tumors from 22 female patients who underwent thyroidectomy for thyroid carcinoma. All patients had multiple and separate papillary carcinomas (range, two to six). Genomic DNA samples were prepared from formalin-fixed, paraffin-embedded tissue sections using laser-capture microdissection. Loss of heterozygosity assays for three microsatellite polymorphic markers for putative tumor suppressor genes on chromosomes 3p25 (D3S1597), 9p21 (D9S161), and 18p11.22-p11 (D18S53) were done. In addition, X-chromosome inactivation analysis was done on the tumors from all patients. Results:Twenty of 22 (91%) cases showed allelic loss in one or more of the papillary lesions in at least one of the three polymorphic markers analyzed. Concordant allelic loss patterns between coexisting papillary tumors were seen in 20 of 23 (87%) cases. A concordant pattern of nonrandom X-chromosome inactivation in the multiple coexisting papillary lesions was seen in all informative cases. Conclusion: Our data suggest that the multifocal tumors in patients with papillary thyroid carcinoma often arise from the same clone. Thus, intrathryoid metastasis may play an important role in the spread of papillary thyroid carcinoma, a finding that has important therapeutic, diagnostic, and prognostic implications.Papillary thyroid carcinoma is the most common malignancy of the adult thyroid with an average of 20,000 new cases occurring each year. These tumors often present as thyroid nodules or as lymphadenopathy due to metastases (1, 2). Papillary thyroid carcinoma is frequently seen in the setting of Hashimoto's thyroiditis and is more frequently multifocal than any other well-characterized type of thyroid carcinoma. Often, there is a primary tumor that is >1 cm and additional microscopic foci measuring <1 cm (3, 4). Multifocal tumors have been associated with an increased risk of lymph node and distant metastases, suggesting multifocal papillary thyroid cancer may necessitate a unique treatment approach (5).Previous genetic studies have shown follicular thyroid carcinomas to display more extensive loss of heterozygosity and increased chromosomal instability than papillary carcinomas, which may be responsible for the more indolent course and better prognosis of papillary lesions (6 -8). The RET, NTRK1, RAS, and BRAF genes have been shown to participate in the pathogenesis of papillary thyroid carcinoma (9 -18). Subsequent clonality studies have yielded variable results, with independent clonal origin of multifocal papi...

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“…Mazaferri and Kloos (2001) published findings based on 1510 patients (without distant metastases at the time of initial therapy) who were followed-up for 40 years, that RAI ablation to be an independent variable that reduced locoregional recurrence, distant metastases, and cancer death. However, these findings were not confirmed in an analysis performed in an identical fashion on a series of 1542 patients treated at Mayo clinic (Grebe and Hay, 1997). In 2002, Mayo Clinic again presented data of 2444 patients and claimed that RAI ablation had not improved already excellent cause specific mortality (CSM) and tumor recurrence (TR) in low risk patients managed by near total thyroidectomy and conservative nodal excision (Hey et al, 2002).…”

Section: Remnant Ablation or Not In Low Risk Wdtc?mentioning

confidence: 99%

Controversies about Radioactive Iodine-131 Remnant Ablation in Low Risk Thyroid Cancers: Are We Near A Consensus?

Zaman¹,

Fatima²,

Padhy³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Well differentiated thyroid cancers (WDTC), including papillary (80%) and follicular (10%) types, are the most common endocrine cancers globally. Over the last few decades most the diagnosed cases have fallen into low risk categories. Radioactive iodine-131 (RAI) has an established role in reducing recurrence and improving the survival in high risk patients. In patients with primary tumor size <1 cm, RAI is not recommended by many thyroid societies. However, low risk WDTC has been an arena of major controversies, most importantly the role and dose of adjuvant RAI for remnant ablation to minimize chances of recurrence and improving survival. This review is an attempt to update readers about the previous and existing practice based on results of nonrandomized trials and evolving trends fueled by recently published randomized studies.

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Follicular cell-derived thyroid carcinomas

Cited by 59 publications

References 96 publications

Selective use of radioactive iodine in the postoperative management of patients with papillary and follicular thyroid carcinoma

Selective use of radioactive iodine in the postoperative management of patients with papillary and follicular thyroid carcinoma

Molecular Evidence for the Same Clonal Origin of Multifocal Papillary Thyroid Carcinomas

Controversies about Radioactive Iodine-131 Remnant Ablation in Low Risk Thyroid Cancers: Are We Near A Consensus?

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