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  • Differential Clinicopathological Risk and Prognosis of Major Papillary Thyroid Cancer Variants

    Author(s)
    Shi, Xiaoguang
    Liu, Rengyun
    Basolo, Fulvio
    Giannini, Riccardo
    Shen, Xiaopei
    Teng, Di
    Guan, Haixia
    Shan, Zhongyan
    Teng, Weiping
    Musholt, Thomas J
    Al-Kuraya, Khawla
    Fugazzola, Laura
    Colombo, Carla
    Kebebew, Electron
    Jarzab, Barbara
    Czarniecka, Agnieszka
    Bendlova, Bela
    Sykorova, Vlasta
    Sobrinho-Simoes, Manuel
    Soares, Paula
    Shong, Young Kee
    Kim, Tae Yong
    Cheng, Sonia
    Asa, Sylvia L
    Viola, David
    Elisei, Rossella
    Yip, Linwah
    Mian, Caterina
    Vianello, Federica
    Wang, Yangang
    Zhao, Shihua
    Oler, Gisele
    Cerutti, Janete M
    Puxeddu, Efisio
    Qu, Shen
    Wei, Qing
    Xu, Huixiong
    O'Neill, Christine J
    Sywak, Mark S
    Clifton-Bligh, Roderick
    Lam, Alfred K
    Riesco-Eizaguirre, Garcilaso
    Santisteban, Pilar
    Yu, Hongyu
    Tallini, Giovanni
    Holt, Elizabeth H
    Vasko, Vasily
    Xing, Mingzhao
    Griffith University Author(s)
    Lam, Alfred K.
    Year published
    2016
    Metadata
    Show full item record
    Abstract
    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 ...
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    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.
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    Journal Title
    Journal of Clinical Endocrinology and Metabolism
    Volume
    101
    Issue
    1
    DOI
    https://doi.org/10.1210/jc.2015-2917
    Subject
    Clinical sciences
    Clinical sciences not elsewhere classified
    Publication URI
    http://hdl.handle.net/10072/100108
    Collection
    • Journal articles

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