Risk Factors for Distant Metastasis in Patients with Follicular Thyroid Carcinoma
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초록
Purpose: The major issue of follicular thyroid carcinoma (FTC) diagnosed after hemithyroidectomy is whether to undergo further treatments. The aim of this study is to examine the clinico-pathological characteristics of FTC and to evaluate the risk factors for distant metastasis. Methods: From 1993 to 2010, 274 patients underwent initial thyroid surgery and were subsequently diagnosed as FTC. After review of the histological sections by an experienced pathologist, 211 patients were confirmed as FTC and were enrolled in this study. Clinicopathological features were compared based on the presence or absence of distant metastases, and the risk factors for distant metastases and distant metastases-free survival (DMFS) rates were analyzed.Results: The patients included 39 males (18.5%) and 172 females (81.5%), with a mean age of 44.0±14.5 years. The median follow-up period was 99.5 months (range, 13.0∼222.0). Distant metastases were detected in 23 patients (10.9%), including 15 synchronous distant metastases and 8 metachronous distant metastases. In multivariate analysis, age ≥45 years, widely invasive FTC, tumor size ≥4.3 cm, and vascular invasion were independent risk factors for distant metastasis. DMFS rates in patients with these risk factors were significantly poorer than those in patients without these risk factors. Conclusion: Older age, aggressive histological classification, larger tumor size, and vascular invasion were independent risk factors for distant metastasis. FTC patients with these risk factors may be candidates for further treatments after diagnostic thyroid hemithyroidec-tomy.
Abstract
Purpose: The major issue of follicular thyroid carcinoma (FTC) diagnosed after hemithyroidectomy is whether to undergo further treatments. The aim of this study is to examine the clinico-pathological characteristics of FTC and to evaluate the risk factors for distant metastasis. Methods: From 1993 to 2010, 274 patients underwent initial thyroid surgery and were subsequently diagnosed as FTC. After review of the histological sections by an experienced pathologist, 211 patients were confirmed as FTC and were enrolled in this study. Clinicopathological features were compared based on the presence or absence of distant metastases, and the risk factors for distant metastases and distant metastases-free survival (DMFS) rates were analyzed.Results: The patients included 39 males (18.5%) and 172 females (81.5%), with a mean age of 44.0±14.5 years. The median follow-up period was 99.5 months (range, 13.0∼222.0). Distant metastases were detected in 23 patients (10.9%), including 15 synchronous distant metastases and 8 metachronous distant metastases. In multivariate analysis, age ≥45 years, widely invasive FTC, tumor size ≥4.3 cm, and vascular invasion were independent risk factors for distant metastasis. DMFS rates in patients with these risk factors were significantly poorer than those in patients without these risk factors. Conclusion: Older age, aggressive histological classification, larger tumor size, and vascular invasion were independent risk factors for distant metastasis. FTC patients with these risk factors may be candidates for further treatments after diagnostic thyroid hemithyroidec-tomy.
참고문헌 (14)
- DeLellis R, "WHO Classification of tumours. Pathology and genetics of tumours of endocrine organs", pp.73~76 (2004), IARC Press
- Lo CY, "Follicular thyroid carcinoma:the role of histology and staging systems in predicting survival", Ann Surg, 242, pp.708~715 (2005)
- Ito Y, "Prognosis and prognostic factors of follicular carcinoma in Japan: importance of postoperative pathological examination", World J Surg, 31, pp.1417~1424 (2007)
- Goffredo P, "Can minimally invasive follicular thyroid cancer be approached as a benign lesion?: a population-level analysis of survival among 1,200patients", Ann Surg Oncol, 20, pp.767~772 (2013)
- 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)
- Ito Y, "Prognostic significance of patient age in minimally and widely invasive follicular thyroid carcinoma: investigation of three age groups", Endocr J, 61, pp.265~271 (2014)
- Ban EJ, "Follicular thyroid cancer: minimally invasive tumours can give rise to metastases", ANZ J Surg, 82, pp.136~139 (2012)
- Sugino K, "Outcomes and prognostic factors of 251 patients with minimally invasive follicular thyroid carcinoma", Thyroid, 22, pp.798~804 (2012)
- Delbridge L, "Minimally invasive follicular thyroid carcinoma: completion thyroidectomy or not?", ANZ J Surg, 72, pp.844~845 (2002)
- 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)
- Ito Y, "Prognostic factors of minimally invasive follicular thyroid carcinoma: extensive vascular invasion significantly affects patient prognosis", Endocr J, 60, pp.637~642 (2013)
- 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-Hürthle 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)
- Lang BH, "Staging systems for follicular thyroid carcinoma: application to 171 consecutive patients treated in a tertiary referral centre", Endocr Relat Cancer, 14, pp.29~42 (2007)