Aims We aimed to study the clinicopathological and molecular features of high‐grade non‐anaplastic thyroid carcinomas (HGTCs), a carcinoma with a prognosis intermediate between those of well‐differentiated carcinoma and anaplastic carcinoma. Methods and results This study included 364 HGTC patients: 200 patients (54.9%) were diagnosed with poorly differentiated thyroid carcinoma (PDTC), based on the Turin consensus (HGTC‐PDTC), and 164 were diagnosed with high‐grade features that did not meet the Turin criteria (HGTC‐nonPDTC). HGTCs are aggressive: the 3‐year, 5‐year, 10‐year and 20‐year disease‐specific survival (DSS) rates were 89%, 76%, 60%, and 35%, respectively. Although DSS was similar between HGTC‐PDTC and HGTC‐nonPDTC patients, HGTC‐PDTC was associated with higher rate of radioactive iodine avidity, a higher frequency of RAS mutations, a lower frequency of BRAF V600E mutations and a higher propensity for distant metastasis (DM) than HGTC‐nonPDTC. Independent clinicopathological markers of worse outcome were: older age, male sex, extensive necrosis and lack of encapsulation for DSS; older age, male sex and vascular invasion for DM‐free survival; and older age, necrosis, positive margins and lymph node metastasis for locoregional recurrence‐free survival. The frequencies of BRAF, RAS, TERT, TP53 and PTEN alterations were 28%, 40%, 55%, 11%, and 10%, respectively. TP53, PTEN and TERT were independent molecular markers associated with an unfavourable outcome, independently of clinicopathological parameters. The coexistence of BRAF V600E and TERT promoter mutation increased the risk of DM. Conclusions The above data support the classification of HGTC as a single group with two distinct subtypes based on tumour differentiation: HGTC‐PDTC and HGTC‐nonPDTC.
To assess the racial differences in survival of children with acute lymphocytic leukemia, we analyzed data for 1,675 white and 126 black children, diagnosed from 1955 to 1969. Blacks had a significantly shorter median survival and lower one-year and three-year survival rates than whites. There was substantial variation in racial differences by age. In addition, much of the variation between races seemed to be due to socioeconimic factors rather than strictly racial ones. Identification of the specific factors responsible for the poorer survival of children from lower social classes is sorely needed.
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