Well-differentiated thyroid cancer

Jossart, Gregg H.; Clark, Orlo H.

doi:10.1016/0011-3840(94)90063-9

Cited by 97 publications

(93 citation statements)

References 153 publications

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“…Papillary thyroid cancer is responsible for 46.4% of bone metastases, compared with follicular thyroid cancer accounting for 32.1%. This seems to be due to the fact that papillary thyroid cancer constitutes the largest portion of thyroid cancer, approximately 80% to 85% of malignant epithelial thyroid tumors [20]. However, papillary thyroid cancer is less likely to metastasize to bone than follicular thyroid cancer.…”

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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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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“…The incidence rate of thyroid cancer in 2007 almost doubled since 1997, climbing to 11.99 per 100,000 (1). Approximately 90% of thyroid cancer cases are well differentiated, and are usually classified as papillary thyroid carcinoma (PTC) or follicular thyroid carcinoma (FTC) based on the predominant histology (2). Over the past decade, it has been recognized that only about half of the PTC cases are of classical type (C-PTC), whereas the remaining 50% of cases are made up of various histologic variants (3,4).…”

Section: Introductionmentioning

confidence: 99%

Follicular Variant of Papillary Thyroid Carcinoma is a Unique Clinical Entity: A Population-Based Study of 10,740 Cases

Schneider

Leverson

et al. 2013

Thyroid

126

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Background: Follicular variant of papillary thyroid carcinoma (FV-PTC) has been increasingly diagnosed in recent years. However, little is known about its clinical behavior. The purpose of this study was to determine the disease characteristics of FV-PTC, and to compare it with classical papillary thyroid carcinoma (C-PTC) and follicular thyroid carcinoma (FTC). Methods: All cases of C-PTC, FV-PTC, and FTC larger than 1 cm in the Surveillance, Epidemiology and End Results (SEER) Cancer Database from 1988 to 2007 were identified. Tumor behavior and patient survival were compared among these three groups. Different risk factors for disease-specific mortality in each group were evaluated by multivariate analysis. Results: More than 36,000 surgical cases were identified, including 21,796 C-PTCs, 10,740 FV-PTCs, and 3958 FTCs. Extrathyroidal extension and lymph-node metastases were more common in FV-PTC than in FTC, but significantly less common than in C-PTC ( p < 0.0001). Distant metastasis rates were present in 2% of patients with FV-PTC, in 1% with C-PTC, and in 4% with FTC ( p < 0.0001). The 10-year disease-specific survival for patients with FV-PTC was 98%, similar to C-PTC (97%) but better than FTC (94%, p < 0.0001). Being over the age of 45 years remained a strong risk factor for disease-specific mortality in both FV-PTC and C-PTC, while the presence of extrathyroidal extension and distant metastases were stronger predictors of disease-specific mortality in FV-PTC than in C-PTC. Conclusions: FV-PTC is a common variant of PTC. Its clinical behavior is unique and represents an intermediate entity with clinical features that are between C-PTC and FTC. Interestingly, despite the variations in clinical behavior, the long-term outcome of these patients remains excellent and similar to C-PTC.

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“…44 Sin embargo, algunos autores realizan y recomiendan la realización de una tiroidectomía total de rutina basándose en la elevada frecuencia de multicentralidad y afectación bilateral de la glándula, 26 la necesidad de tratamiento ablativo posterior con radioyodo, la posibilidad de uso de la tiroglobulina como marcador de recidiva si se ha eliminado todo el tejido tiroideo y la potencial transformación en carcinoma anaplásico. 17,44,46,47 En pacientes de alto riesgo, sí se recomienda la realización de tiroidectomía bilateral ya que ha demostrado aumentar la supervivencia de forma significativa. 44 En nuestro caso, se realizó una tiroidectomía total por considerarse de alto riesgo, dado su modo de presentación.…”

Section: Discussionunclassified

“…44 However some authors carryout, and they recommend carrying out, a routine total thyroidectomy based on the high frequency of multicentrality and bilateral involvement of the gland, 26 the need for posterior ablative treatment with radioiodine, the possibility of using thyroglobulin as a recurrence marker if all thyroid tissue has been eliminated, and the potential transformation to anaplastic carcinoma. 17,44,46,47 In high-risk patients, carrying out a bilateral thyroidectomy is recommended as it has been shown to increase survival significantly. 44 In this case of ours, a total thyroidectomy was carried out as it was considered a highrisk case, given the presentation mode.…”

Section: Discussionmentioning

confidence: 99%