Outcome after Treatment of High-Risk Papillary and Non-Hurthle-Cell Follicular Thyroid Carcinoma

Taylor, Terry

doi:10.7326/0003-4819-129-8-199810150-00007

Cited by 175 publications

(94 citation statements)

References 20 publications

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“…These findings are in accordance with other studies (Johnson et al 1988, Taylor et al 1998) published on this subject, which show the tall cell variant as an indicator of poor prognosis, the diffuse sclerosing variant to be of intermediate risk (Carcangiu & Bianchi 1989, Chan 1990, and the follicular variant as well as pure PTC as having a positive prognosis (Chen & Rosai 1977, Carcangiu et al 1985, Tielens et al 1994, Ortiz Sebastian et al 2000. Growth characteristics of FTC (minimally or widely invasive) were statistically significant in univariate analysis, but could not be confirmed as independent risk factors.…”

Section: Discussionsupporting

confidence: 82%

“…Most authors recommend total or near-total thyroidectomy in order to reduce the risk of recurrence and thus improve survival (Clark 1982, Samaan et al 1992, Mazzaferri & Jhiang 1994, Loh et al 1997, Hay et al 1998, Duren et al 2000, while others prefer less radical surgery for all low risk patients regardless of the T-classification (Cady 1998). This recommendation is supported by studies of DeGroot et al (1995) who could not find an increase in carcinoma-specific mortality when less radical surgical procedures were chosen.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic factors of papillary and follicular thyroid cancer: differences in an iodine-replete endemic goiter region.

Passler

Scheuba²,

Prager³

et al. 2004

Endocr Relat Cancer

141

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Papillary (PTC) and follicular thyroid carcinoma (FTC) are known as differentiated thyroid carcinoma (DTC). Nevertheless, according to the UICC/AJCC (TNM) classification PTC and FTC are frequently analyzed as one cancer. The aim of this study is to show differences in outcome and specific prognostic factors in an iodine-replete endemic goiter region.Six hundred and three patients with DTC treated within a 35-year-period were retrospectively analyzed with respect to carcinoma-specific survival. Prognostic factors were tested for their significance using univariate and multivariate analysis.The histological type (PTC versus FTC) was found to be a highly significant factor -carcinomaspecific survival both in univariate ðP < 0:001Þ and multivariate analyses ðP ¼ 0:003Þ was significantly different. Univariate analysis revealed patients' age, extra-thyroid tumor spread, lymph node and distant metastases, increasing tumor size, and the tall cell variant to be significant prognostic factors for PTC patients. Age !45 years, positive lymph nodes and increasing tumor size were confirmed as independent prognostic factors. Univariate analysis of FTC patients revealed age at presentation, gender, extrathyroidal tumor spread, lymph node and distant metastases, increasing tumor size, multifocality, widely invasive tumor growth and oxyphilic variant to be factors bearing prognostic significance. The presence of distant metastases and increasing tumor size could be identified as independent prognostic factors for FTC patients.This study shows distinctive differences in prognostic factors of PTC and FTC: independent factors predicting poor prognosis are age !45 years, positive lymph nodes and increasing tumor size for PTC, and distant metastases and increasing tumor size for FTC. PTC and FTC patients should be analyzed and reported separately.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Prognostic factors of papillary and follicular thyroid cancer: differences in an iodine-replete endemic goiter region.

Passler

Scheuba²,

Prager³

et al. 2004

Endocr Relat Cancer

141

View full text Add to dashboard Cite

show abstract

“…The goals of this treatment are to destroy residual thyroid tissue in an effort to decrease the risk for recurrent locoregional disease and to facilitate long-term surveillance with whole-body iodine scans and/or stimulated thyroglobulin measurements (62,63). A number of large, retrospective studies show a significant reduction in the rates of disease recurrence (61,98,99,126) and cause-specific mortality (98,99,(126)(127)(128). However, other similar studies show no such benefit, at least among the majority of patients with papillary thyroid carcinoma, who are at the lowest risk for mortality (68,101,(128)(129)(130)(131).…”

Section: What Is the Role Of Postoperative Radioiodine Remnant Ablation?mentioning

confidence: 99%

Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Taskforce

Cooper

Doherty

Haugen

et al. 2006

Thyroid

1,921

938

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“…The data collection and analytical methods of the NTCTCS have been described elsewhere (8,9,(14)(15)(16)(17)(18)(19)(20). Briefly, 11 North American centers contributed patient data, with registration beginning in January 1987 (this data analysis captures patients registered through to 2011).…”

Section: Registry Protocol and Data Collectionmentioning

confidence: 99%

Reassessing the NTCTCS Staging Systems for Differentiated Thyroid Cancer, Including Age at Diagnosis

McLeod

Jonklaas

Brierley

et al. 2015

Thyroid

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Background: Thyroid cancer is unique for having age as a staging variable. Recently, the commonly used age cut-point of 45 years has been questioned. Objective: This study assessed alternate staging systems on the outcome of overall survival, and compared these with current National Thyroid Cancer Treatment Cooperative Study (NTCTCS) staging systems for papillary and follicular thyroid cancer. Methods: A total of 4721 patients with differentiated thyroid cancer were assessed. Five potential alternate staging systems were generated at age cut-points in five-year increments from 35 to 70 years, and tested for model discrimination (Harrell's C-statistic) and calibration (R 2 ). The best five models for papillary and follicular cancer were further tested with bootstrap resampling and significance testing for discrimination. Results: The best five alternate papillary cancer systems had age cut-points of 45-50 years, with the highest scoring model using 50 years. No significant difference in C-statistic was found between the best alternate and current NTCTCS systems ( p = 0.200). The best five alternate follicular cancer systems had age cut-points of 50-55 years, with the highest scoring model using 50 years. All five best alternate staging systems performed better compared with the current system ( p = 0.003-0.035). There was no significant difference in discrimination between the best alternate system (cut-point age 50 years) and the best system of cut-point age 45 years ( p = 0.197). Conclusions:No alternate papillary cancer systems assessed were significantly better than the current system. New alternate staging systems for follicular cancer appear to be better than the current NTCTCS system, although they require external validation.

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Outcome after Treatment of High-Risk Papillary and Non-Hurthle-Cell Follicular Thyroid Carcinoma

Cited by 175 publications

References 20 publications

Prognostic factors of papillary and follicular thyroid cancer: differences in an iodine-replete endemic goiter region.

Prognostic factors of papillary and follicular thyroid cancer: differences in an iodine-replete endemic goiter region.

Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Taskforce

Reassessing the NTCTCS Staging Systems for Differentiated Thyroid Cancer, Including Age at Diagnosis

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