Survival and Prognostic Factors in Thyroid Carcinoma

Joensuu, Heikki; Klemi, Pekka; Paul, Robert; Tuominen, Jukka

doi:10.3109/02841868609136413

Cited by 37 publications

(20 citation statements)

References 17 publications

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“…Pure follicular lesions previously have been found to have a worse prognosis, stage for stage, when compared with patients with papillary carcinoma or mixed papillary/follicular lesions. 14,15 One of the main weaknesses of our study is a lack of data on recurrences. The NMTR has not gathered data on recurrences in patients with thyroid cancer.…”

Section: Discussionmentioning

confidence: 94%

Localized well-differentiated thyroid carcinoma: Survival analysis of prognostic factors and131I therapy

Morris

Boyle

Stidley

et al. 1998

Annals of Surgical Oncology

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Section: Discussionmentioning

confidence: 94%

Localized well-differentiated thyroid carcinoma: Survival analysis of prognostic factors and131I therapy

Morris

Boyle

Stidley

et al. 1998

Annals of Surgical Oncology

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“…thyroid cancer, such as papillary and follicular types. In general, these cancers are some of the most indolent solid neoplasms, with favorable long-term survival [12]. Papillary thyroid cancer shows a 10-year overall survival rate, ranging between 74% and 93%, as compared to follicular thyroid cancer, with a 10-year survival rate of 43% to 94% [13].…”

Section: Discussionmentioning

confidence: 99%

Clinical Features of Bone Metastases Resulting from Thyroid Cancer: A Review of 28 Patients over a 20-year Period

et al. 2005

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Abstract. Bone is the second most frequent site of metastasis resulting from thyroid cancer. Many studies have investigated clinical features and prognostic factors of distant metastases stemming from thyroid cancer in Western countries. The purpose of this study was to review clinical characteristics of Korean patients with bone metastasis originating from thyroid cancer. Between January 1985 and August 2004, 28 patients with thyroid cancer were diagnosed with bone metastases at the Yonsei Severance Hospital in Seoul, Korea. Their clinical characteristics were analyzed retrospectively. Incidence of bone metastasis from follicular thyroid cancer was 6.8% (9 of 132 patients), and 0.4% (13 of 3,154 patients) from papillary thyroid cancer, with an odds ratio of 17.67 (95% confidence interval; 7.41-42). Twelve patients had no symptoms of bone metastasis. Overall mean number of metastasis sites was 2.6 ± 1.9, and 12 patients had a solitary bone metastasis. Survival rates between the synchronous and metachronous metastasis groups were not significantly different, and the number of metastasis sites did not affect survival. However, the survival of patients that underwent curative treatment was longer than those with palliation (P = 0.0317). In Korea, the overall incidence of bone metastasis resulting from thyroid cancer was less than our expectation. Many patients were asymptomatic, and had a tendency of undergoing less aggressive or palliative treatment, even though the long-term survival of distant metastasis resulting from thyroid cancer with active treatment is relatively good. Further studies of the prognostic factors and effectiveness of various treatments of these patients are needed to enhance survival. DISTANT metastasis in thyroid cancer is well known and develops in 7% to 23% of patients with differentiated thyroid cancer [1]. In anaplastic thyroid cancer, 25% to 50% of patients may have synchronous pulmonary metastases at the time of diagnosis [2], while 20% of patients with sporadic medullary thyroid carcinoma had distant metastases at the time of diagnosis [3]. Bone is the second most common site of metastasis resulting from thyroid cancer after lung. The incidence of bone metastasis varies along with the degree of differentiation and histologic subtypes of thyroid cancer. Follicular thyroid cancer is the most common histologic origin of bone metastasis among well-differentiated thyroid cancer, with incidences ranging from 7% to 28% [4,5], but papillary thyroid cancer has been identified as the least likely subtype to cause bone metastases with incidences ranging from 1.4% to 7% in many reports [6][7][8]. According to the time interval from thyroid cancer diagnosis to detection of distant metastasis, metastatic thyroid cancer is classified into two types: synchronous metasatsis (SM) and metachronous metastasis (MM). The differences between these two

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“…To date, several prognostic factors have been identified in Western countries; these include tumor size, distant metastasis at surgery, age, marked vascular invasion, Hurthle cell type, and male gender [94][95][96][97][98][99][100][101][102][103][104][105][106][107][108][109]. Ten-year CSS rates ranged from 43 to 80%, which tended to be worse than those of papillary carcinoma possibly because of the higher frequency of distant metastasis.…”

Section: Prognostic Factors For Follicular Carcinomamentioning

confidence: 99%

Prognostic Factors and Therapeutic Strategies for Differentiated Carcinomas of the Thyroid

2009

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Abstract. Differentiated thyroid carcinoma originates from thyroid follicular cells and is the most prominent malignancy of the endocrine organs. There are two histological types of differentiated carcinoma, namely, papillary and follicular carcinoma. According to reports from Western countries, papillary carcinoma comprises 85.3% of thyroid malignancies in whites, and 72.3% in blacks [1,2]. In Japan, a previous study showed that the prevalence of papillary carcinoma was 78.4% based on material registered between 1977 and 1986 [3], but according to recent findings reported in 2004 by Japanese Society of Thyroid Surgeons (JSTS), papillary carcinoma accounted for as much as 93% of all thyroid carcinomas. Papillary carcinoma frequently metastasizes to the regional lymph node and shows multicentricity in the thyroid gland. It usually shows a typical ultrasonographic appearance and can be rather easily diagnosed by fine needle aspiration biopsy (FNAB) [4][5][6]. Follicular carcinoma accounts for 10.9-20.5% of the patients in the United States [1,2]. In Japan, the prevalence of follicular carcinoma was reported to be 17.2% [3], but it decreased to 5% in a report by JSTS in 2004. This carcinoma is only occasionally diagnosed preoperatively, because it is hard to discriminate follicular carcinoma from benign adenoma on imaging studies and cytologic findings. In contrast to papillary carcinoma, follicular carcinoma more often metastasizes to distant organs than regional lymph nodes. In Japan, the prevalence of papillary carcinoma increased and that of follicular carcinoma decreased between reports from 1977 to 1986 and that in 2004, which may be because follicular variant of papillary carcinoma was classified into follicular carcinoma in the previous results. Generally, these carcinomas show an indolent character, but when the lesion dedifferentiates and becomes undifferentiated carcinoma, it displays very rapid growth with an adverse prognosis and is regarded even as the most aggressive malignancy among human solid carcinomas [7,8]. Furthermore, cases showing certain characteristics are likely to be constantly progressive and even become life-threatening. Such cases should be regarded as "high-risk" requiring careful and extensive surgical treatment and postoperative follow-up. Indeed, it is most important for physicians to correctly distinguish high-risk cases from those with an indolent character, although how to evaluate the biological characteristics of thyroid carcinoma and how to identify high-risk cases remains highly controversial. In this review, the methods of distinguishing high-risk cases and the appropriate therapeutic strategies for papillary and follicular carcinomas predominantly based on our experience are emphasized and our proposals for therapies including surgical treatment are demonstrated.

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Survival and Prognostic Factors in Thyroid Carcinoma

Cited by 37 publications

References 17 publications

Localized well-differentiated thyroid carcinoma: Survival analysis of prognostic factors and131I therapy

Localized well-differentiated thyroid carcinoma: Survival analysis of prognostic factors and131I therapy

Clinical Features of Bone Metastases Resulting from Thyroid Cancer: A Review of 28 Patients over a 20-year Period

Prognostic Factors and Therapeutic Strategies for Differentiated Carcinomas of the Thyroid

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