Clinicopathologic features and prognostic factors of tall cell variant of papillary thyroid carcinoma

Okuyucu, Kürşat; Alagöz, Engin; Arslan, Nuri; Emer, Özdeş; İnce, Semra; Deveci, Salih; Ayan, Aslı; Taşlıpınar, Abdullah; Günalp, Bengül; Azal, Ömer

doi:10.1097/mnm.0000000000000360

Cited by 15 publications

(14 citation statements)

References 23 publications

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“…Our Spearman's rho calculation confirms that older age also correlates with a higher proportion of TCs. It is also evident that TCV correlates with extrathyroidal extension, 11,13,14 which is also confirmed by our calculations.…”

Section: Discussionsupporting

confidence: 90%

“…[9][10][11][12][13][14][15][16][17] It is associated with more extra-thyroidal extensions 11,13,14 and greater risk for recurrence. 6,9,14,16,18,19 According to a 2017 update, World Health Organization (WHO) defines a TCV as a tumour showing typical nuclear features of PTC consisting of at least 30% tumour cells two to three times as tall as they are wide with an abundant eosinophilic cytoplasm. 7 The percentage of tall cells (TCs) needed for a PTC to be regarded as TCV is, however, under debate and varies greatly from 30%, 11,20 to 50%, 18 to as high as 75%.…”

Section: Introductionmentioning

confidence: 99%

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The prognostic significance of tall cells in papillary thyroid carcinoma: A case-control study

et al. 2018

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The subtype of the papillary thyroid carcinoma tall-cell variant has a worse prognosis than does the conventional papillary type (papillary thyroid carcinoma). The new World Health Organization 2017 classification defines a tall-cell variant as a tumour consisting of over 30% of cells that are two or three times as tall as they are wide. However, thresholds have differed. Our aim was to study how tall cells affect the prognosis of papillary thyroid carcinoma patients and to determine, for such cells, a cut-off percentage. Our cohort included 65 papillary thyroid carcinoma patients who underwent surgery at Helsinki University Hospital between 1973 and 1996: originally, 36 otherwise-matched patient pairs, eventually comprising 34 patients with an adverse outcome plus 31 who had recovered. All samples were digitally scanned and scored by two investigators based on tall cell composition. The cohort was analysed with four tall cell thresholds: 10%, 30%, 50% and 70% with a median follow-up of 22 years. In survival analysis, only the 70% threshold showed a correlation with reduced overall survival, disease-specific survival and relapse-free survival. A correlation also emerged with death from papillary thyroid carcinoma. In multivariate analysis, a 70% cut-off and age at diagnosis significantly affected DSS. Increasing tall cell score correlated with increasing age and extrathyroidal extensions. A tall cell composition of 10%, 30% or 50% showed no correlation with adverse outcome and suggests that the choice of pathologists reporting tall-cell variant should be a 70% threshold.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

The prognostic significance of tall cells in papillary thyroid carcinoma: A case-control study

et al. 2018

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“…In addition, in the univariate and multivariate analyses, we demonstrated that an advanced T stage, PTCs located in the isthmus might contribute to central lymph node metastasis, and our result was consistent with other previous reports. [15,16] …”

Section: Discussionmentioning

confidence: 99%

Lymph node metastasis characteristics of papillary thyroid carcinoma located in the isthmus

Lei²,

Qian³

et al. 2017

Medicine

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The frequency and pattern of lymph node metastasis and the extent of dissection for isthmic papillary thyroid carcinoma (PTC) remain unclear, and the aim of this present study was to evaluate these characteristics and to attempt to detect the best surgical protocol for isthmic PTCs. A total of 3185 consecutive patients with PTCs were reviewed. Of these patients, 47 with a single isthmic PTC were enrolled in our study, and matched 47 patients with a single PTC located in the unilateral lobe were randomly selected and added for comparison of their baseline tumor characteristics and lymph node metastasis characteristics. Univariate and multivariate analyses were performed to determine the risk factors for central lymph node metastasis in PTCs. The isthmic PTCs showed a higher rate of capsule invasion (P = .013) and advanced pathological N stage (P = .038) compared to the PTCs located in the lobe; meanwhile, pathological evidence of central lymph node metastasis (P = .040) was more frequent in the isthmic PTC group than in the control group. The univariate and multivariate analyses indicated that the tumors located in the isthmus (hazard ratio [HR]: 2.769; 95% confidence interval [CI]: 1.124–6.826; P = .027) and those with advanced (T2–4) pathological classifications (HR: 4.282; 95% CI: 1.224–14.976; P = .023) were independent risk factors for central lymph node metastasis in PTC patients. Due to the higher rate of pathological central lymph node metastasis and independent risk factors for central lymph node metastasis, total thyroidectomy, and bilateral central lymph node dissection should be considered the standard surgical protocol for isthmic PTCs.

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“…We assessed the studies individually by sequentially excluding each of the 19 studies from our meta-analysis. Using this method, we found that I 2 decreased to 41.8% when we excluded the study by Okuyucu et.al [11], therefore, we concluded that the heterogeneity was mainly caused by this particular study (data not shown).…”

Section: Resultsmentioning

confidence: 79%

“…Studies on the clinicopathological characteristics and prognostic outcome of TCV have had controversial results [10, 11]. No differences were found in some studies between the prognoses of TCV and cPTC, [10] whereas results of other studies and the current American Thyroid Association Guidelines for Differentiated Thyroid Cancer indicate that TCV displays more aggressive pathological characteristics at diagnosis and a poorer prognosis than cPTC does [1, 12].…”

Section: Introductionmentioning

confidence: 99%

A comparison of the clinicopathological features and prognoses of the classical and the tall cell variant of papillary thyroid cancer: a meta-analysis

et al. 2016

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Papillary thyroid cancer (PTC) accounts for 80–90% of all thyroid malignancies. The tall cell variant (TCV) is a rare aggressive histotype of PTC. We performed a meta-analysis to compare the clinicopathological characteristics and prognostic factors of TCV with those of classical papillary thyroid carcinoma (cPTC). A literature search was performed using the PubMed and EMBASE databases using Medical Subject Headings and keywords. Twenty studies that included 1871 patients with TCV and 75323 patients with cPTC were included in our meta-analysis. Odds ratios and confidence intervals were calculated for each study. Patients with TCV were associated with multifocality, higher TNM stage, extrathyroidal extension, vascular invasion, lymph node metastasis, distant metastasis, BRAF mutation, disease-specific survival, and overall survival. We found that TCV cases were associated with more aggressive clinicopathological characteristics and poorer prognoses than cPTC cases were. Our results suggest that TCV is a high-risk PTC that warrants aggressive treatment and follow-up strategies.

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Clinicopathologic features and prognostic factors of tall cell variant of papillary thyroid carcinoma

Abstract: TCV has a higher incidence of local or distant metastasis and mortality rate. Thus, it must be treated with the highest possible I ablation doses and followed up carefully.

Cited by 15 publications

References 23 publications

The prognostic significance of tall cells in papillary thyroid carcinoma: A case-control study

The prognostic significance of tall cells in papillary thyroid carcinoma: A case-control study

Lymph node metastasis characteristics of papillary thyroid carcinoma located in the isthmus

A comparison of the clinicopathological features and prognoses of the classical and the tall cell variant of papillary thyroid cancer: a meta-analysis

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