Long Term Outcome of Minimally Invasive Follicular Thyroid Carcinoma according to Risk Group Stratification
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Purpose: This study evaluated the risk factors for distant metastasis in patients with minimally invasive follicular thyroid carcinoma (MIFTC) and compared distant metastasis-free survival (DMFS) rates between the groups divided based on the number of involved risk factors. Methods: Patients were divided into 4 groups based on the number of involved risk factors; group 0 with no risk factor, group 1 with any one risk factor, group 2 with any 2 risk factors, and group 3 with all risk factors. Results: The 195 patients were enrolled in this study. Distant metastasis was detected in 15 patients (7.7%). In the multivariate analysis, age ≥ 45 years (hazard ratio [HR]=5.95; 95% confidence interval [CI]=1.44–24.55; P=0.014), primary tumor size >4.0 cm (HR=4.79; 95% CI=1.18–19.33; P=0.028), and extensive vascular invasion with ≥4 foci (HR=19.63; 95% CI=5.18–74.39; P<0.001) were identified as independent risk factors for distant metastasis. Group 1 tended to have poorer DMFS rates as compared with group 0, but there was no significant difference (P=0.069). DMFS rates of group 2 and 3 were significantly poorer than those of group 1 (P<0.001 and <0.001, respectively). DMFS rates of group 3 were also significantly poorer than those of group 2 (P=0.004). Conclusion: MIFTC patients with no or only one distant metastasis-related risk factor may become candidates for close observation without additional treatments with respect toDMFS rates.
Abstract
Purpose: This study evaluated the risk factors for distant metastasis in patients with minimally invasive follicular thyroid carcinoma (MIFTC) and compared distant metastasis-free survival (DMFS) rates between the groups divided based on the number of involved risk factors. Methods: Patients were divided into 4 groups based on the number of involved risk factors; group 0 with no risk factor, group 1 with any one risk factor, group 2 with any 2 risk factors, and group 3 with all risk factors. Results: The 195 patients were enrolled in this study. Distant metastasis was detected in 15 patients (7.7%). In the multivariate analysis, age ≥ 45 years (hazard ratio [HR]=5.95; 95% confidence interval [CI]=1.44–24.55; P=0.014), primary tumor size >4.0 cm (HR=4.79; 95% CI=1.18–19.33; P=0.028), and extensive vascular invasion with ≥4 foci (HR=19.63; 95% CI=5.18–74.39; P<0.001) were identified as independent risk factors for distant metastasis. Group 1 tended to have poorer DMFS rates as compared with group 0, but there was no significant difference (P=0.069). DMFS rates of group 2 and 3 were significantly poorer than those of group 1 (P<0.001 and <0.001, respectively). DMFS rates of group 3 were also significantly poorer than those of group 2 (P=0.004). Conclusion: MIFTC patients with no or only one distant metastasis-related risk factor may become candidates for close observation without additional treatments with respect toDMFS rates.
참고문헌 (15)
- DeLellis RA, "Pathology and Genetics of Tumours of Endocrine Organs" (2004), IARC Press
- Asari R, "Follicular thyroid carcinoma in an iodine-replete endemic goiter region: a prospectively collected, retrospectively analyzed clinical trial", Ann Surg, 249, pp.1023~1031 (2009)
- Ban EJ, "Follicular thyroid cancer: minimally invasive tumours can give rise to metastases", ANZ J Surg, 82, pp.136~139 (2012)
- Goffredo P, "Can minimally invasive follicular thyroid cancer be approached as a benign lesion?: a population-level analysis of survival among 1,200 patients", Ann Surg Oncol, 20, pp.767~772 (2013)
- Huang CC, "Diagnostic and therapeutic strategies for minimally and widely invasive follicular thyroid carcinomas", Surg Oncol, 20, pp.1~6 (2011)
- Lo CY, "Follicular thyroid carcinoma: the role of histology and staging systems in predicting survival", Ann Surg, 242, pp.708~715 (2005)
- Sugino K, "Outcomes and prognostic factors of 251 patients with minimally invasive follicular thyroid carcinoma", Thyroid, 22, pp.798~804 (2012)
- Ito Y, "Prognostic factors of minimally invasive follicular thyroid carcinoma: extensive vascular invasion significantly affects patient prognosis", Endocr J, 60, pp.637~642 (2013)
- O'Neill CJ, "Management of follicular thyroid carcinoma should be individualised based on degree of capsular and vascular invasion", Eur J Surg Oncol, 37, pp.181~185 (2011)
- Sugino K, "Prognosis and prognostic factors for distant metastases and tumor mortality in follicular thyroid carcinoma", Thyroid, 21, pp.751~757 (2011)
- Sugino K, "Does completion thyroidectomy improve the outcome of patients with minimally invasive follicular carcinoma of the thyroid?", Ann Surg Oncol, 21, pp.2981~2986 (2014)
- Besic N, "Is patient's age a prognostic factor for follicular thyroid carcinoma in the TNM classification system?", Thyroid, 15, pp.439~448 (2005)
- Witte J, "Importance of lymph node metastases in follicular thyroid cancer", World J Surg, 26, pp.1017~1022 (2002)
- D'Avanzo A, "Follicular thyroid carcinoma: histology and prognosis", Cancer, 100, pp.1123~1129 (2004)
- Collini P, "Extensive vascular invasion is a marker of risk of relapse in encapsulated non-Hurthle cell follicular carcinoma of the thyroid gland: a clinicopathological study of 18 consecutive cases from a single institution with a 11-year median follow-up", Histopathology, 44, pp.35~39 (2004)