Follicular and Hurthle cell carcinoma of the thyroid in iodine-sufficient area: retrospective analysis of Korean multicenter data
2
조회
0
다운로드
5
인용
0
참고문헌
키워드
초록
Background/Aims: Follicular thyroid carcinoma (FTC) and Hurthle cell carcinoma(HCC) of the thyroid are relatively uncommon thyroid malignancies in iodine-sufficient areas. In this study we evaluated the clinical behavior, prognosticfactors and treatment outcomes of FTC and HCC in Korea. Methods: This multicenter study included 483 patients with FTC and 80 patientswith HCC who underwent an initial surgery between 1995 and 2006 in one of thefour tertiary referral hospitals in Korea. We evaluated clinicopathological factorsassociated with distant metastases and recurrence during a median of 6 years offollow-up. Results: HCC patients were significantly older (49 years vs. 43 years; p < 0.001) andhad more lymphovascular invasions (22% vs. 14%; p = 0.03) compared with FTCpatients. Distant metastases were confirmed in 40 patients (8%) in the FTC groupand in two patients (3%) in the HCC group (p = 0.07). Distant metastases weresignificantly associated with older age, widely invasive cancer and extrathyroidalinvasion. Only 14 patients (3%) had recurrent disease and there was no significantdifference between FTC and HCC groups (p = 0.38). Recurrence was associatedwith larger tumor size and cervical lymph node metastasis. Conclusions: HCC patients were older and had more lymphovascular invasionsthan FTC patients. However, FTC and HCC patients had similar initial clinicopathologicalfeatures. Older age, wide invasiveness and extrathyroidal invasionwere independent risk factors for predicting distant metastases in FTC and HCCpatients.
Abstract
Background/Aims: Follicular thyroid carcinoma (FTC) and Hurthle cell carcinoma(HCC) of the thyroid are relatively uncommon thyroid malignancies in iodine-sufficient areas. In this study we evaluated the clinical behavior, prognosticfactors and treatment outcomes of FTC and HCC in Korea. Methods: This multicenter study included 483 patients with FTC and 80 patientswith HCC who underwent an initial surgery between 1995 and 2006 in one of thefour tertiary referral hospitals in Korea. We evaluated clinicopathological factorsassociated with distant metastases and recurrence during a median of 6 years offollow-up. Results: HCC patients were significantly older (49 years vs. 43 years; p < 0.001) andhad more lymphovascular invasions (22% vs. 14%; p = 0.03) compared with FTCpatients. Distant metastases were confirmed in 40 patients (8%) in the FTC groupand in two patients (3%) in the HCC group (p = 0.07). Distant metastases weresignificantly associated with older age, widely invasive cancer and extrathyroidalinvasion. Only 14 patients (3%) had recurrent disease and there was no significantdifference between FTC and HCC groups (p = 0.38). Recurrence was associatedwith larger tumor size and cervical lymph node metastasis. Conclusions: HCC patients were older and had more lymphovascular invasionsthan FTC patients. However, FTC and HCC patients had similar initial clinicopathologicalfeatures. Older age, wide invasiveness and extrathyroidal invasionwere independent risk factors for predicting distant metastases in FTC and HCCpatients.
참고문헌 (24)
- Xing M, "Molecular pathogenesis and mechanisms of thyroid cancer", Nat Rev Cancer, 13, pp.184~199 (2013)
- Correa P, "Endocrine gland cancer", Cancer, 75(1 Suppl), pp.338~352 (1995)
- Grebe SK, "Follicular thyroid cancer", Endocrinol Metab Clin North Am, 24, pp.761~801 (1995)
- Passler C, "Prognostic factors of papillary and follicular thyroid cancer: differences in an iodine-replete endemic goiter region", Endocr Relat Cancer, 11, pp.131~139 (2004)
- DeGroot LJ, "Morbidity and mortality in follicular thyroid cancer", J Clin Endocrinol Metab, 80, pp.2946~2953 (1995)
- Brennan MD, "Follicular thyroid cancer treated at the Mayo Clinic, 1946 through 1970: initial manifestations, pathologic findings, therapy, and outcome", Mayo Clin Proc, 66, pp.11~22 (1991)
- Donohue JH, "Do the prognoses of papillary and follicular thyroid carcinomas differ?", Am J Surg, 148, pp.168~173 (1984)
- Baloch ZW, "Our approach to follicular-patterned lesions of the thyroid", J Clin Pathol, 60, pp.244~250 (2007)
- Hedinger C, "The WHO histological classification of thyroid tumors: a commentary on the second edition", Cancer, 63, pp.908~911 (1989)
- Lo CY, "Follicular thyroid carcinoma: the role of histology and staging systems in predicting survival", Ann Surg, 242, pp.708~715 (2005)
- Phitayakorn R, "Follicular and Hurthle cell carcinoma of the thyroid gland", Surg Oncol Clin N Am, 15, pp.603~623 (2006)
- Ganly I, "Genomic dissection of Hurthle cell carcinoma reveals a unique class of thyroid malignancy", J Clin Endocrinol Metab, 98, pp.E962~E972 (2013)
- Gosain AK, "Hurthle cell neoplasms: malignant potential", Arch Surg, 119, pp.515~519 (1984)
- American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, "Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer", Thyroid, 19, pp.1167~1214 (2009)
- Baloch ZW, "Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference", Diagn Cytopathol, 36, pp.425~437 (2008)
- Sorrenti S, "Comparison of malignancy rate in thyroid nodules with cytology of indeterminate follicular or indeterminate Hurthle cell neoplasm", Thyroid, 19, pp.355~360 (2009)
- Pu RT, "Does Hurthle cell lesion", neoplasm predict malignancy more than follicular lesion, Diagn Cytopathol, pp.2006, 34[DOI]
- Lopez-Penabad L, "Prognostic factors in patients with Hurthle cell neoplasms of the thyroid", Cancer, 97, pp.1186~1194 (2003)
- Ruegemer JJ, "Distant metastases in differentiated thyroid carcinoma: a multivariate analysis of prognostic variables", J Clin Endocrinol Metab, 67, pp.501~508 (1988)
- Goffredo P, "Hurthle cell carcinoma:a population-level analysis of 3311 patients", Cancer, 119, pp.504~511 (2013)
- 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)
- D’Avanzo A, "Follicular thyroid carcinoma: histology and prognosis", Cancer, 100, pp.1123~1129 (2004)
- Sugino K, "Prognosis and prognostic factors for distant metastases and tumor mortality in follicular thyroid carcinoma", Thyroid, 21, pp.751~757 (2011)
- 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)