Histological subtype is the most important determinant of survival in metastatic papillary thyroid cancer

Abstract

BackgroundPapillary thyroid cancer (PTC) comprises the commonest type of thyroid cancer and carries the highest rate of survival. However, when metastatic disease occurs, survival is significantly affected.MethodsWe aimed to identify prognostic histopathological and clinical factors that modify survival in metastatic PTC. All cases of metastatic PTC treated at our department in the last 20 years were reviewed and analyzed.ResultsHistological subtype was the most important determinant of survival, as classic PTC demonstrated clearly improved survival compared to follicular subtype of PTC and other less frequently seen histological subtypes. The instant risk of death for the other histological subtypes was 4.56 times higher than the risk for the classic papillary type. Overall, a 10-year survival of 76.6% in our patients was seen.ConclusionsPatients with aggressive variants of PTC are more at risk for the development of metastatic disease. In these patients, established treatment modalities (surgery, radioiodine therapy) should be offered promptly, as well as close follow-up.

The thyroid gland and the process of aging; what is new?

“…Presumably, it is a consequence of increased mitotic activity of these tumors and increased likelihood of distant metastases [46]. It is known that in general population patients with aggressive variants of PTC have higher risk for the metastatic disease development [47]. The potential role of NDRG2 gene expression in the development and progression of PTC is also raised [48].…”

Papillary Thyroid Carcinoma

“…The most common site of distant metastases from papillary thyroid carcinoma is the lung followed by mediastinal lymph nodes. Less often, distant metastases may appear in bones, central nervous system, liver, pericardium and pleura, kidney, pancreas, skin and muscle, gastrointestinal tract [11]. The treatment of choice for papillary carcinoma of thyroid is total thyroidectomy [12].…”

Ciągła stratyfikacja ryzyka w zróżnicowanym raku tarczycy (DTC) — stymulowane stężenie tyreoglobuliny (Tg) w surowicy, przed leczeniem uzupełniającym radiojodem (RAI), najważniejszym czynnikiem ryzyka nawrotu raka u pacjentów M0

“…However, other reports did not demonstrate any differences in DFS and OS depending on histology [2,9]. The importance of thyroid capsule infiltration, angioinvasion, and multifocality as prognostic factors was emphasised by numerous retrospective analyses that showed their negative impact on both OS [7,8,[11][12][13] and DFS [8,11,12], but other papers questioned these data [9,10,14,15]. Divergent opinions were one of the reasons to change this approach in the risk stratification in DTC patients.…”