Prognostic Importance of Histologic Vascular Invasion in Papillary Thyroid Carcinoma

Falvo, L; Catania, A; D’Andrea, Vito; Marzullo, A; Giustiniani, Maria Cristina; Antoni, Enrico De

doi:10.1097/01.sla.0000157317.60536.08

Cited by 115 publications

(97 citation statements)

References 19 publications

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“…Our findings revealed that low risk group had better prognosis than intermediate and high risk. This result was similar to many publish studies (McConahey et al, 1986;Gemsenjager et al, 2001;Falvo et al, 2005;Lang et al, 2006).…”

Section: Discussionsupporting

confidence: 79%

Factors Affecting Disease-Free Status of Differentiated Thyroid Carcinoma Patients

Thamnirat

Utamakul²,

Chamroonrat³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Purpose: The study aim was to assess factors that impact on the outcome of radioiodine therapy in patients diagnosed with differentiated thyroid carcinoma (DTC). Materials and Methods: We performed a retrospective cohort study on 256 patients with DTC who underwent thyroidectomy and received radioiodine therapy during December 2003 to January 2012. All patients were followed up for at least 1 year. They were considered diseasefree by the criteria of the revised American Thyroid Association Management Guideline for Patients with Thyroid nodules and DTC (ATA guideline 2009). Results: On Cox univariate analysis, factors associated with disease-free status were age<45, stage I tumor, low risk group by histopathology, unifocal tumor involvement, stimulated serum Tg level at 1st dose of radioiodine therapy and no distant metastasis from 1st post-treatment WBS (post RxWBS). On multivariate analysis, stage I tumor and stimulated serum Tg level at 1st dose of radioiodine therapy < 30 ng/mL were the significant prognostic factors that increased disease-free rate by 1.73 times and 2.60 times, respectively (P-value <0.05). Conclusions: Factors affecting the outcome of radioiodine therapy in our study were age, stage, risk of recurrence by histopathology, unifocal tumor involvement and 1st postRxWBS findings. From these factors, stage I tumor and stimulated serum Tg level at 1st dose of radioiodine therapy were independent prognostic factors that substantial increase the disease-free rate.

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Section: Discussionsupporting

confidence: 79%

Factors Affecting Disease-Free Status of Differentiated Thyroid Carcinoma Patients

Thamnirat

Utamakul²,

Chamroonrat³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…[10][11][12][13][31][32][33] Nishida et al 33 reported vascular invasion in 46.9% of papillary thyroid carcinomas and distant metastases in only 8% of angioinvasive papillary thyroid carcinomas, suggesting that the criteria applied were not specific enough to identify high risk patients. Our review identified rigid criteria of vascular invasion in only 3% of thyroid carcinomas.…”

Section: Discussionmentioning

confidence: 99%

Pathological definition and clinical significance of vascular invasion in thyroid carcinomas of follicular epithelial derivation

2011

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There are many controversies involving the diagnostic criteria and treatment of well-differentiated thyroid carcinoma. Vascular invasion has been identified as an important and independent prognosticator in many cancers. The majority of pathologists recognize the importance of vascular invasion as a diagnostic marker of malignancy in follicular lesions of thyroid; however, several reports have suggested that angioinvasion is not a predictor of bad prognosis in thyroid carcinomas. We suggest that the criteria for diagnosing angioinvasion in thyroid carcinomas as well as in other endocrine tumors are inconsistent and the controversy may be attributed to application of inappropriate criteria. We carried out a study of a potential cause of artefactual vascular invasion in a series of autopsy thyroids and established the morphology of mimics of angioinvasion. We then reviewed retrospectively the clinicopathological features of a series of 4000 thyroid carcinomas of follicular epithelial derivation to identify the features and significance of the most rigid criteria of vascular invasion: tumor cells invading through a vessel wall and thrombus adherent to intravascular tumor. These features were identified in 118 (3%) lesions. Follow-up information was available for 98 patients. Of these, 35% developed distant metastases. When using the rigid criteria, B1/3 of angioinvasive well-differentiated thyroid carcinomas and 1/2 of angioinvasive poorly differentiated thyroid carcinomas developed distant metastases at a mean 5.3 years of follow-up. Our results indicate that the application of rigid criteria for vascular invasion provide a clinically relevant prediction of distant metastasis in patients with thyroid carcinomas, especially in well-differentiated thyroid carcinomas.

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“…Solid tumors tend to invade vessels to obtain abundant oxygen and nutrients for cell metabolism and proliferation-associated biosynthesis. Clinical studies have confirmed that patients with vessel invasion by tumors had an increased risk of recurrence and a poorer prognosis compared with those who had tumor-free vessels in a range of cancers, including breast cancer, hepatocellular carcinoma and papillary thyroid carcinoma (23)(24)(25). In addition, in patients without pre-operative metastasis, resection of the tumor-invaded vessels conferred a survival benefit, with a similar long-term prognosis compared with patients without vessel invasion by tumors (26,27).…”

Section: Hypothesismentioning

confidence: 65%

A circulating tumor cell cluster-based model for tumor metastasis (Hypothesis)

Hong

Li²,

Zhang

2016

Oncology Letters

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Abstract. Metastasis is the major cause of mortality in patients with malignancies; however, the mechanisms of tumor cell dissemination and metastasis formation are obscure. Circulating tumor cells (CTCs) are believed to be a critical step for distant metastasis and are associated with a poor patient prognosis. The precise processes of metastasis formation from CTCs are vague. In the present study, we hypothesize that two CTC cluster-based mechanisms of tumor cell inoculation in ectopic organs may be viable: i) Formation of a micro-cancer embolus due to interception of CTC clusters by small vessels; and ii) formation of micrometastasis in an extravasation-dependent or -independent manner. Pathological evidence of micro-cancer emboli is critical for the verifications of this hypothesis. If proved true, this hypothesis will provide a novel perspective for cancer metastasis and has valuable clinical implications.

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Prognostic Importance of Histologic Vascular Invasion in Papillary Thyroid Carcinoma

Cited by 115 publications

References 19 publications

Factors Affecting Disease-Free Status of Differentiated Thyroid Carcinoma Patients

Factors Affecting Disease-Free Status of Differentiated Thyroid Carcinoma Patients

Pathological definition and clinical significance of vascular invasion in thyroid carcinomas of follicular epithelial derivation

A circulating tumor cell cluster-based model for tumor metastasis (Hypothesis)

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