Do aggressive variants of papillary thyroid carcinoma have worse clinical outcome than classic papillary thyroid carcinoma?

Song, Eyun; Jeon, Min Ji; Oh, Hye-Seon; Han, Minkyu; Lee, Yu‐Mi; Kim, Tae Yong; Chung, Ki-Wook; Kim, Won; Shong, Young Kee; Song, Dong Eun; Kim, Won Gu

doi:10.1530/eje-17-0991

Cited by 51 publications

(53 citation statements)

References 28 publications

(51 reference statements)

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“…2b) and a poor prognosis. [113][114][115][116] It is a rare subtype of PTC accounting for only 0.15-0.2% of all PTC 115 ( Table 2). As typical PTC-type nuclear features are not seen in columnar cell variant PTC, 117 it was excluded from the PTC lineage and classified in other tumors in the Japanese classification of thyroid tumors proposed by the Guidelines for Clinical Practice for the Management of Thyroid Nodules in Japan 2015.…”

Section: Columnar Cell Variant Ptcmentioning

confidence: 99%

The new 4th edition World Health Organization classification for thyroid tumors, Asian perspectives

Kakudo

Bychkov

Bai

et al. 2018

Pathology International

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Section: Columnar Cell Variant Ptcmentioning

confidence: 99%

The new 4th edition World Health Organization classification for thyroid tumors, Asian perspectives

Kakudo

Bychkov

Bai

et al. 2018

Pathology International

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“…Recently, a retrospective study compared DFS in 144 patients with three aggressive variants of PTC and 763 patients with classic PTC, after propensity score matching by age, sex, primary tumour size, LN metastasis and ETE. This study found that the group of aggressive PTC variants had significantly lower DFS than the matched classic PTC group (HR = 2.16 (95% CI 1.12-4.16), P = 0.018) (Song et al 2018). However, when TCVs and CCVs were evaluated separately, there was no significant differences in DFS and dynamic risk stratification (DRS) between patients with TCV (n = 121) and matched classic PTC, whereas the CCV group (n = 18) had significantly poorer DFS than the matched classic PTC group (HR = 12.19 (95% CI 2.11-70.33), P = 0.005) (Song et al 2018).…”

Section: Histological Variantsmentioning

confidence: 65%

“…However, when TCVs and CCVs were evaluated separately, there was no significant differences in DFS and dynamic risk stratification (DRS) between patients with TCV (n = 121) and matched classic PTC, whereas the CCV group (n = 18) had significantly poorer DFS than the matched classic PTC group (HR = 12.19 (95% CI 2.11-70.33), P = 0.005) (Song et al 2018). Furthermore, CCV was an independent risk factor for structural recurrence in multivariate analysis (HR = 4.28 (95% CI 1.66-11.00) P = 0.001), suggesting the use of individualised therapeutic approaches for each type of aggressive PTC variant (Song et al 2018).…”

Section: Histological Variantsmentioning

confidence: 95%

Lobectomy in patients with differentiated thyroid cancer: indications and follow-up

Park

Yoon

2019

Endocrine-Related Cancer

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The extent of thyroid surgery for patients with low- and intermediate-risk differentiated thyroid carcinoma (DTC), with a primary tumour <4 cm and no extrathyroidal extension (ETE) or lymph node (LN) metastases, has shifted in a more conservative direction. However, clinicopathological risk factors, including microscopic ETE, aggressive histology, vascular invasion in papillary thyroid carcinoma (PTC) and intermediate volume of LN metastases, can only be identified after completing thyroid lobectomy. It is controversial whether patients with these risk factors should immediately undergo complete thyroidectomy and/or radioactive iodine remnant ablation or should be monitored without further treatments. Data are conflicting about the prognostic impact of these risk factors on clinical DTC outcomes. Notably, the recurrence rate in patients who underwent thyroid lobectomy is low and the few recurrences that develop during long-term follow-up can readily be detected by neck ultrasonography and treated by salvage surgery with no impact on survival. These findings suggest that a more conservative approach may be a preferred management strategy over immediate completion surgery, despite a slightly higher risk of structural recurrence. Regarding follow-up of post-lobectomy DTC patients, it is reasonable that an initial risk stratification system based on clinicohistological findings be used to guide the short-term follow-up prior to evaluating the response to initial therapy and that the dynamic risk stratification system based on the response to initial therapy be used to guide long-term follow-up.

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“…The mutation rate of BRAF gene,localed in V600E, was high in CCV-PTC, about 33% [2].There were 3 cases of CCV-PTC found BRAF mutation out of 9 cases, 2 cases with clinical invasive. IHC showed that, the expression of cyclin D1 and Ki -67, in the nucleus, were higher, which P53 weakly positive in in invasive and inert CCV -PTC.…”

Section: Geneticsmentioning

confidence: 89%

“…Papillary thyroid carcinoma is the most common thyroid cancer, about 60%-70%, and often encountered in children and adolescents, especially young women [1][2][3]. Age has a significant impact on prognosis, which is good in young patients and poor in old patients.…”

Section: Introductionmentioning

confidence: 99%

Columnar Cell Variant of Papillary Thyroid Carcinoma: A Clinicopathologic Analystis

Zhang¹

2019

EJCBS

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Background: Papillary Thyroid Carcinoma (PTC) is the Most common thyroid malignancy disease, and it is more common in females. It happened in any age. Mean age at diagnosis is approximately 40 years old. There is history of neck irradiation in 5-10% patients. And non-neoplastic gland may show nuclear aberrations as a result. There is increased incidence in Hashimoto's thyroiditis, but not clear whether there is an increased incidence in Graves' disease. Columnar cell variant of papillary thyroid carcinoma is the rare subtype of PTC, which is reportedly about 0.17%. CCV-PTC was reported in 1986 by Evans for the first time. It is different from the typical papillary carcinoma, not only in morphology but also in biological behavior, and is more aggressive than typical papillary carcinoma. Objective: To study the clinical-pathological links and features of papillary thyroid carcinoma (Columnar cell variant) (CCV-PTC). Methods: 4 cases of CCV-PTC from Chengde medical college affiliated hospital were retrospectively analyzed, to observe its clinical features, histological, immunophenotype, and metastasis. And the literature of CCV-PTC were reviewed. Results: Out of the 4 patients, two male patients of 70 and 53 years old, two female patients of 64 and 68 years old. Microscopically, tumor cells arranged in multistage papillary structure, with pseudostratified columnar epithelium, same to gastrointestinal and lung metastatic carcinoma. IHC: Ki-67(5-15%), calcitonin(-), TG(+), ck19(-), TTF-1(+), CgA(-), SyN(-),ck(+/-). Conclusion: CCV-PTC is a special subtype of PTC with a more aggressive biological behavior, particularly among older people, Immunohistochemical method is helpful for the diagnosis.

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Do aggressive variants of papillary thyroid carcinoma have worse clinical outcome than classic papillary thyroid carcinoma?

Abstract: When other clinicopathological factors were similar, patients with TCV did not exhibit unfavorable clinical outcome, whereas those with CCV had significantly poorer clinical outcome. Individualized therapeutic approach might be necessary for each type of AV-PTCs.

Cited by 51 publications

References 28 publications

The new 4th edition World Health Organization classification for thyroid tumors, Asian perspectives

The new 4th edition World Health Organization classification for thyroid tumors, Asian perspectives

Lobectomy in patients with differentiated thyroid cancer: indications and follow-up

Columnar Cell Variant of Papillary Thyroid Carcinoma: A Clinicopathologic Analystis

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