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dc.contributor.authorShi, Xiaoguang
dc.contributor.authorLiu, Rengyun
dc.contributor.authorBasolo, Fulvio
dc.contributor.authorGiannini, Riccardo
dc.contributor.authorShen, Xiaopei
dc.contributor.authorTeng, Di
dc.contributor.authorGuan, Haixia
dc.contributor.authorShan, Zhongyan
dc.contributor.authorTeng, Weiping
dc.contributor.authorMusholt, Thomas J
dc.contributor.authorAl-Kuraya, Khawla
dc.contributor.authorFugazzola, Laura
dc.contributor.authorColombo, Carla
dc.contributor.authorKebebew, Electron
dc.contributor.authorJarzab, Barbara
dc.contributor.authorCzarniecka, Agnieszka
dc.contributor.authorBendlova, Bela
dc.contributor.authorSykorova, Vlasta
dc.contributor.authorSobrinho-Simoes, Manuel
dc.contributor.authorSoares, Paula
dc.contributor.authorShong, Young Kee
dc.contributor.authorKim, Tae Yong
dc.contributor.authorCheng, Sonia
dc.contributor.authorAsa, Sylvia L
dc.contributor.authorViola, David
dc.contributor.authorElisei, Rossella
dc.contributor.authorYip, Linwah
dc.contributor.authorMian, Caterina
dc.contributor.authorVianello, Federica
dc.contributor.authorWang, Yangang
dc.contributor.authorZhao, Shihua
dc.contributor.authorOler, Gisele
dc.contributor.authorCerutti, Janete M
dc.contributor.authorPuxeddu, Efisio
dc.contributor.authorQu, Shen
dc.contributor.authorWei, Qing
dc.contributor.authorXu, Huixiong
dc.contributor.authorO'Neill, Christine J
dc.contributor.authorSywak, Mark S
dc.contributor.authorClifton-Bligh, Roderick
dc.contributor.authorLam, Alfred K
dc.contributor.authorRiesco-Eizaguirre, Garcilaso
dc.contributor.authorSantisteban, Pilar
dc.contributor.authorYu, Hongyu
dc.contributor.authorTallini, Giovanni
dc.contributor.authorHolt, Elizabeth H
dc.contributor.authorVasko, Vasily
dc.contributor.authorXing, Mingzhao
dc.description.abstractContext: 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.
dc.publisherThe Endocrine Society
dc.relation.ispartofjournalJournal of Clinical Endocrinology and Metabolism
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchClinical sciences not elsewhere classified
dc.titleDifferential Clinicopathological Risk and Prognosis of Major Papillary Thyroid Cancer Variants
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.hasfulltextNo Full Text
gro.griffith.authorLam, Alfred K.

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