TITLE

Prognostic Importance of Sclerosing Variant in Papillary Thyroid Carcinoma

AUTHOR(S)
Falvo, Laura; Giacomelli, Laura; D'Andrea, Vito; Marzullo, Antonella; Guerriero, Gabriella; De Antoni, Enrico
PUB. DATE
May 2006
SOURCE
American Surgeon;May2006, Vol. 72 Issue 5, p438
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The diffuse sclerosing variant (DSV) of papillary thyroid carcinoma is known for its high aggressiveness, high incidence of lymph node metastases, and high incidence of pulmonary metastases, and thus its consequently poorer prognosis. In this study, we undertook a retrospective analysis of papillary thyroid carcinomas to assess whether DSV can be considered a predictive factor for prognosis. We performed a retrospective evaluation of the Department's database of patients with papillary thyroid carcinoma who had undergone total thyroidectomy from January 1992 to December 2000. Group I consisted of 83 DSV patients and Group II was 168 pure papillary carcinoma (PC) patients. A significant prevalence of multinodular thyroid disorder on diagnosis was found for PC (P < 0.05), whereas with DSV, there was a significantly higher prevalence of post-thyroiditis nodular thyroid disorder than with PC (P < 0.001). The incidence of laterocervical lymph node pathology on diagnosis was significantly higher for DSV (P < 0.05). In 3.6 per cent of PC patients and 15.7 per cent of DSV patients, we observed recurrences in the regional lymph nodes (P < 0.001). We found 1.2 per cent distant metastases in PC patients and 7.2 per cent in DSV patients (P < 0.05). One PC patient (0.6%) and three DSV patients (3.6%) died of tumor-related causes (P < 0.05). Our study demonstrated that diffuse sclerosing carcinoma leads to a poorer prognosis to the extent that its classification as an autonomous clinical pathological entity is justified. In conclusion, we can state that DSV is a form of papillary thyroid tumor characterized by its higher aggressiveness, diffuse intrathyroid growth, and high incidence of lymph node and pulmonary metastasis. Ultimately, this means a poorer prognosis. In the presence of risk factors indicating a possible increase in biological aggressiveness, adequate postoperative treatment and close follow-up become essential.
ACCESSION #
20838249

 

Related Articles

  • Lateral Lymph Node Metastasis in Papillary Thyroid Carcinoma: Results of Therapeutic Lymph Node Dissection. Yoo Seung Chung; Jee Young Kim; Ja-Seong Bae; Byung-Joo Song; Jeong Soo Kim; Hae Myung Jeon; Sang-Seol Jeong; Eung Kook Kim; Woo-Chan Park // Thyroid;Mar2009, Vol. 19 Issue 3, p241 

    Background:Cervical lymph node metastases are quite common in papillary thyroid cancer (PTC) and they usually spread in a contiguous fashion. However, “skip metastasis,” defined as lateral lymph node metastasis without central lymph node metastasis, also occurs in patients with PTC....

  • Pattern, predictors, and recurrence of cervical lymph node metastases in papillary thyroid cancer. Lan Shi; Haiping Song; Huiping Zhu; Dapeng Li; Ning Zhang // Contemporary Oncology / Wspolczesna Onkologia;2013, Vol. 17 Issue 6, p504 

    Aim of the study: This study investigated the pattern, predictors, and recurrence of node metastasis in papillary thyroid cancer patients. Material and methods: One hundred and 65 papillary thyroid cancer (PTC) patients who underwent total thyroidectomy and cervical lymph node (LN) dissection...

  • Prevalence, Clinicopathologic Features, and Somatic Genetic Mutation Profile in Familial Versus Sporadic Nonmedullary Thyroid Cancer. Willieford Moses; Julie Weng; Electron Kebebew // Thyroid;Apr2011, Vol. 21 Issue 4, p367 

    Background:Although hereditary nonmedullary thyroid cancer is recognized as a distinct and isolated familial syndrome, the precise prevalence and genetic basis are poorly understood. Moreover, whether familial nonmedullary thyroid cancer (FNMTC) has a more aggressive clinical behavior is...

  • Extent of surgery in clinically evident but operable MTC - when is central and/or lateral lympadenectomy indicated? Gimm, Oliver // Thyroid Research;2013, Vol. 6 Issue S1, p1 

    Medullary thyroid carcinoma (MTC) metastasizes very early lymphogeneously. It has been shown that the presence of lymph node metastases is associated with a worse outcome. Postoperative biochemical cure, i.e. normalization of posttherapeutical calcitonin levels, has been shown to correlate with...

  • Hybrid-type endoscopic thyroidectomy (HET: Tori's method) for differentiated thyroid carcinoma including invasion to the trachea. Tori, Masayuki // Surgical Endoscopy;Mar2014, Vol. 28 Issue 3, p902 

    Background: Endoscopic thyroidectomy (ET) or robotic thyroidectomy is yet to be applied to thyroid carcinoma invasive to the trachea and to wide lymph node node metastasis. On the other hand, small-incision thyroidectomy lacks sufficient working space and clear vision. The author has newly...

  • A 29-Year Retrospective Review of Papillary Thyroid Cancer in One Institution. Jen-Der Lin; Szu-Tah Chen; Chuen Hsueh; Tzu-Chieh Chao // Thyroid;Jun2007, Vol. 17 Issue 6, p535 

    Objective: The goal of this study was to determine whether conservative surgical therapy had been adequate for low-risk patients with papillary thyroid cancer. Study design and patients: 1,931 patients were categorized as either low risk or high risk, using tumor–node–metastasis...

  • Skip metastases in medullary thyroid carcinoma: A single-center experience. Marcos Tavares; Pedro Michaluart; Fabio Montenegro; Sergio Arap; Maria Sodre; Flavio Takeda; Lenine Brandao; Sergio Toledo; Alberto Ferraz // Surgery Today;Jun2008, Vol. 38 Issue 6, p499 

    Abstract Purpose  Total thyroidectomy (TT) with level VI and VII central neck dissection is the initial treatment for medullary thyroid carcinoma (MTC) without identifiable neck metastasis. Level II to V lateral neck dissection is performed if neck metastasis is present or...

  • Multivariate analysis of prognostic factors for differentiated thyroid carcinoma in children. Jarzab, Barbara; Junak, Daria Handkiewicz; WLoch, Jan; Kalemba, Barbara; Roskosz, Józef; Kukulska, Aleksandra; Puch, Zbigniew // European Journal of Nuclear Medicine;2000, Vol. 27 Issue 7, p833 

    Abstract. At most centres, the standard treatment for differentiated thyroid cancer (DTC) comprises total thyroidectomy, radioiodine treatment and thyroid-stimulating hormone (TSH) suppressive therapy. There is, however, considerable disagreement over the appropriate treatment for DTC in...

  • Identification of Continuity of Transected Nerve on Sonography After Neck Dissection: Direct Sign of Traumatic Neuroma. Ha, Eun Ju; Lee, Jeong Hyun; Lim, Hyun Kyung; Kim, Won Bae; Baek, Jung Hwan // Thyroid;Dec2011, Vol. 21 Issue 12, p1385 

    Background: Traumatic neuroma can be confused with a metastatic lymph node after neck dissection for malignancy, thereby increasing patient anxiety and necessitating fine needle aspiration (FNA). To date, however, there have been no reports showing a direct ultrasonographic (US) sign of...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics