CONTEXT: Individualized management, incorporating papillary thyroid cancer (PTC) variant-specific risk, is conceivably a useful treatment strategy for PTC, which awaits comprehensive data demonstrating differential risks of PTC variants to support. OBJECTIVE: This study sought to establish the differential clinicopathological risk of major PTC variants: conventional PTC (CPTC), follicular-variant PTC (FVPTC), and tall-cell PTC (TCPTC). METHODS: This was a retrospective study of clinicopathological outcomes of 6282 PTC patients (4799 females and 1483 males) from 26 centers and The Cancer Genome Atlas in 14 countries with a median age of 44 years (interquartile range, 33-56 y) and median follow-up time of 37 months (interquartile range, 15-82 mo). RESULTS: The cohort consisted of 4702 (74.8%) patients with CPTC, 1126 (17.9%) with FVPTC, and 239 (3.8%) with TCPTC. The prevalence of high-risk parameters was significantly different among the three variants, including extrathyroidal invasion, lymph node metastasis, stages III/IV, disease recurrence, mortality, and the use (need) of radioiodine treatment (all P < .001), being highest in TCPTC, lowest in FVPTC, and intermediate in CPTC, following an order of TCPTC > CPTC ≫ FVPTC. Recurrence and mortality in TCPTC, CPTC, and FVPTC were 27.3 and 6.7%, 16.1 and 2.5%, and 9.1 and 0.6%, corresponding to events per 1000 person-years (95% confidence interval [CI]) of 92.47 (64.66-132.26) and 24.61 (12.31-49.21), 34.46 (30.71-38.66), and 5.87 (4.37-7.88), and 24.73 (18.34-33.35) and 1.68 (0.54-5.21), respectively. Mortality hazard ratios of CPTC and TCPTC over FVPTC were 3.44 (95% CI, 1.07-11.11) and 14.96 (95% CI, 3.93-56.89), respectively. Kaplan-Meier survival analyses showed the best prognosis in FVPTC, worst in TCPTC, and intermediate in CPTC in disease recurrence-free probability and disease-specific patient survival. This was particularly the case in patients at least 45 years old. CONCLUSION: This large multicenter study demonstrates differential prognostic risks of the three major PTC variants and establishes a unique risk order of TCPTC > CPTC ≫ FVPTC, providing important clinical implications for specific variant-based management of PTC.
- MeSH
- dospělí MeSH
- frekvence genu MeSH
- hodnocení rizik MeSH
- karcinom epidemiologie genetika patologie MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru * MeSH
- metastázy nádorů patologie MeSH
- nádory štítné žlázy epidemiologie genetika patologie MeSH
- následné studie MeSH
- prevalence MeSH
- prognóza MeSH
- radioterapie statistika a číselné údaje MeSH
- retrospektivní studie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
Endocrinology and metabolism clinics of North America, ISSN 0889-8529 vol. 37, no. 2, June 2008
xviii, 298-557 s. : il., tab. ; 24 cm
- MeSH
- adjuvantní radioterapie MeSH
- metastázy nádorů prevence a kontrola MeSH
- nádorové biomarkery MeSH
- nádory štítné žlázy diagnóza chirurgie terapie MeSH
- Publikační typ
- sborníky MeSH
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- endokrinologie
- onkologie
2nd ed. xiv, 1138 s. : il.
- Konspekt
- Fyziologie člověka a srovnávací fyziologie
- NLK Obory
- endokrinologie
Atlas of tumor pathology, ISSN 0160-6344 ser. 3, fasc. 22
214 s. : il. ; 28 cm
- MeSH
- nádory hypofýzy patologie MeSH
- Publikační typ
- atlasy MeSH
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- onkologie
- neurologie
- patologie