Prognostic Factors of Papillary, Follicular and Medullary Carcinomas of the Thyroid Gland: Retrospective multivariate analysis of 216 patients with a median follow-up of 11 years

Tennvall, Jan; Biörklund, Anders; Möller, T.; Ranstam, Jonas; Åkerman, Måns

doi:10.3109/02841868509134360

Cited by 71 publications

(13 citation statements)

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“…This agrees with our previous report of a poor prognosis with higher grade and probably correlates with the poor outcome associated with cellular atypia or less well-differentiated tumor cells reported by oihers. 28,[38][39][40] Extent of local disease, as a predictor of death from PTC, is in agreement with other studies which have shown an association between extrathyroidal invasion and death there was no correlation between cancer mortality and the presence of metastatic cervical nodes at diagnosis.…”

Section: Presenting Featuressupporting

confidence: 87%

Mortality from papillary thyroid carcinoma: A case-control study of 56 lethal cases

Smith

Hay

Goellner

et al. 1988

Cancer

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To document the presentation, findings, therapy, and postoperative course of lethal papillary thyroid carcinoma (PTC), 56 fatal cases were studied in a retrospective case-matched control fashion. These patients and their controls were taken from a larger series receiving their primary treatment at one institution (Mayo Clinic; 1946-1970). Mean follow-up for the lethal cohort was 8.5 years and 16.6 years for controls. Age, sex, tumor size, histologic grade, extent of disease at presentation, European Organization for Research on Treatment of Cancer (EORTC) and AGES scores (patient's age, tumor grade, tumor extent, and tumor size), and DNA ploidy pattern were found to be significant prognostic factors. The immediate causes of death were most frequently either local airway obstruction or respiratory insufficiency from pulmonary metastases. The results suggest that it is possible, at the time of initial treatment, to assess an individual patient's risk of dying from PTC. Aggressive postoperative adjunctive therapy should be restricted to that minority of patients who are at highest risk of death from PTC.

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Section: Presenting Featuressupporting

confidence: 87%

Mortality from papillary thyroid carcinoma: A case-control study of 56 lethal cases

Smith

Hay

Goellner

et al. 1988

Cancer

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“…Die einfache Kategorisierung grob invasiver follicul/irer Carcinome in TNM-Gruppen (gem/il3 UICC: 58) erwies auch bei Uberpriifung am eigenen Material ihre absolute Berechtigung: Zwischen intrathyroidalen (T < 3) und extrahyroidalen (d. h. Organkapsel-fiberschreitenden) Tumoren (T4) bestanden statistisch signifikante Unterschiede der gesch/itzten fJberlebenskurven, und gleiche Befunde waren zuvor von anderen Autoren, allerdings ohne Elimination der prognostisch giinstigeren gekapselten Tumoren, mitgeteilt worden [16,36,62]. fJbereinstimmend mit Meybier et al [45] ergab sich ferner eine signifikant schlechtere ProZ gnose bei Vorliegen (N1) als bei Fehlen region/irer Lymphknotenmetastasen (NO), wobei -entsprechend Befunden von Ladurner und Hofst/idter [36] -h6here Signifikanz bei Vergleich von N-als von M-Stadien vorlagen.…”

Section: Grob Invasive Carcinomeunclassified

Morphologie und Prognose des follicul�ren Schilddr�sencarcinoms ? Eine klinisch-pathologische und DNS-cytometrische Untersuchung an 95 Tumoren

Schröder

Baischz

Rehpenning

et al. 1987

Langenbecks Arch Chiv

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A retrospective study of 95 follicular thyroid carcinomas was conducted to evaluate the prognostic value of different morphological and clinical features. The biological behaviour of these tumours was primarily influenced by presence or absence of a capsule type of confinement: the frequency of lethal outcome among widely invasive carcinomas was six times higher than among encapsulated neoplasms. Furthermore, dismal prognosis could be demonstrated for tumours occurring in older patients (with a sharp break in the prognosis at the age of 52 years) and for those lesions which displayed oxyphilic metaplasia. The same effect was shown for presence of lymph node metastasis, tumour invasion of the cervical soft tissue and, for the case of encapsulated carcinomas, distant haematogenous spread. Conversely, the degree of differentiation and the patients' sex proved to have no significant influence on prognosis. In 22 carcinomas, cytophotometric and flow-cytometric determinations of DNA values were performed. These procedures revealed to have only limited diagnostic value, since for the majority of the tumours, benignancy or malignancy could not be judged from the DNA histograms. However, DNA measurements proved to contribute valuable information for the prognosis in individual cases of widely invasive follicular carcinomas. The discussion focuses on the diagnostic, therapeutic and prognostic relevance of these findings and on their impact on subclassification of follicular thyroid carcinomas.

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“…In addition, certain pathological features such as marked nuclear atypia, necrosis or vascular invasion are also important (Tennvall et al, 1985;Schindler et al, 1991;Akslen et al, 1993). This information may improve the risk estimation for individual patients.…”

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confidence: 99%

Prognostic impact of EGF-receptor in papillary thyroid carcinoma

Akslen¹,

Myking²,

Salvesen³

et al. 1993

Br J Cancer

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Summary In this study of papillary thyroid carcinomas, immunopositivity for EGF-receptor was present in a majority of the cases (96%), although different staining patterns were observed. A distinct membraneous reaction was found in 46%, whereas cytoplasmatic positivity of various degrees was present in 90% of the cases. Strong cytoplasmic EGF-receptor staining was significantly associated with extra-thyroidal growth of the primary tumour (P = 0.009), and it was furthermore related to decreased recurrence free survival (P = 0.006). Membraneous EGF-receptor staining was not associated with recurrence free survival or patient survival. Multivariate Cox analysis showed that lymph node metastases (P = 0.0009) and cytoplasmic EGFreceptor staining (P = 0.0048) was independent indicators of tumour recurrences in this group of surgically treated papillary thyroid carcinomas.The prognosis of patients with papillary thyroid carcinoma has previously been described in several reports (Byar et al., 1979; Tubiana et al., 1985;Carcangiu et al., 1985;Akslen et al., 1991), and the influence of sex, age and tumour stage has been discussed. In addition, certain pathological features such as marked nuclear atypia, necrosis or vascular invasion are also important (Tennvall et al., 1985;Schindler et al., 1991;Akslen et al., 1993). This information may improve the risk estimation for individual patients.In recent years, alterations in various growth factors and their receptors have been established as important features of the neoplastic process (Wynford-Thomas, 1991), among them epidermal growth factor (EGF) and its receptor (EGF-R). EGF is known to induce cell proliferation in several tissues, and its effect is mediated via a tyrosine kinase type of receptor (Carpenter & Cohen, 1979). It has previously been shown by different methods that EGF-receptors are expressed in papillary thyroid carcinomas (Duh et al., 1985;Lemoine et al., 1991;Mizukami et al., 1991; Mizukami et al., 1992), but the biological significance of this finding in terms of patient prognosis is not known. The purpose of the present study was therefore to perform a retrospective immunohistochemical study of EGF-R expression in a series of papillary thyroid carcinomas with special reference to its prognostic importance. Material and methodsPatients This material has been described previously . Briefly, all 263 patients who were surgically treated for thyroid cancer at the Department of Surgery, Haukeland Hospital, University of Bergen in the period 1971-1985 have been studied retrospectively. After histological revision and subtyping of the carcinomas according to the WHO criteria (Hedinger, 1988), 173 cases were found to be papillary carcinomas with a known primary tumour. One of the main results from our previous study was that very few events were observed in tumours with a diameter of 10 mm or below (microcarcinomas according to the WHO criteria). These were therefore excluded, thereby concentrating on clinically significant papillary carcinomas. Sufficient materia...

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Prognostic Factors of Papillary, Follicular and Medullary Carcinomas of the Thyroid Gland: Retrospective multivariate analysis of 216 patients with a median follow-up of 11 years

Cited by 71 publications

References 14 publications

Mortality from papillary thyroid carcinoma: A case-control study of 56 lethal cases

Mortality from papillary thyroid carcinoma: A case-control study of 56 lethal cases

Morphologie und Prognose des follicul�ren Schilddr�sencarcinoms ? Eine klinisch-pathologische und DNS-cytometrische Untersuchung an 95 Tumoren

Prognostic impact of EGF-receptor in papillary thyroid carcinoma

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