Papillary thyroid carcinoma in Kanazawa, Japan: prognostic significance of histological subtypes

Mizukami, Yuji; Noguchi, Masakuni; Michigishi, Takatoshi; Nonomura, Akitaka; Hashimoto, Takuma; Otake, Sotaro; Nakamura, S.; Matsubara, Fujitsugu

doi:10.1111/j.1365-2559.1992.tb00963.x

Cited by 58 publications

(52 citation statements)

References 30 publications

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“…The published data on the prognostic significance of lymph node metastasis in PTC remains controversial. Some studies have shown that the presence of cervical lymph node metastases or mediastinal and bilateral cervical lymph node metastases was associated with greater mortality (Sellers et al 1992, Mazzaferri & Jhiang 1994, Lin et al 1999) and increased recurrence rates (Mazzaferri et al 1977, McConahey et al 1986, Simpson et al 1987, DeGroot et al 1990, Akslen & Myking 1992, Mizukami et al 1992, Lin et al 1999. However, other studies showed that the presence of lymph node metastases did not significantly impact on cancer mortality (Tubiana et al 1985, McConahey et al 1986, Simpson et al 1987, DeGroot et al 1990, and even had a lower mortality rate than those without nodal metastases (Cady et al 1976).…”

Section: Discussionmentioning

confidence: 99%

Molecular analysis of multifocal papillary thyroid carcinoma

Lin¹,

Finkelstein²,

Zhu³

et al. 2008

Journal of Molecular Endocrinology

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Papillary thyroid carcinoma (PTC) frequently presents as a multifocal process. To study the importance of separating independent primary (IP) from intrathyroid metastatic (ITM) PTC, we examined 19 molecular markers on 42 separate tumors from 18 multifocal PTC cases. In 12 of 18 (66 . 7%) cases, including 6 of 12 (50%) papillary microcarcinoma cases, the same or similar profile of loss of heterozygosities (LOH) and v-raf murine sarcoma viral oncogene homolog B1 (BRAF) mutation was demonstrated, indicating that they were from the same primary and represented ITM. Different profiles of LOHs and BRAF mutation were detected in separate tumors of 6 of 18 cases, indicating that they represented IP. Patients with ITM, including papillary microcarcinoma, had significantly increased lymph node metastasis. The frequencies of LOHs of 17q21, 17p13, 10q23, and 22q13 were higher in tumors with lymph node metastasis, suggesting that these LOHs may be important in increased lymph node metastasis. LOH of 9p21 was found at the highest frequency in PTC (53 . 8%), followed by 1p36 (46 . 2%), 10q23 (34 . 6%), and 22q13 (34 . 6%). Papillary microcarcinoma had acquired similar genomic mutations as conventional PTC, but higher frequencies of mutations of BRAF, 1p36, 18q, and 22q13 were found in the larger PTC, suggesting that they might play a role in the aggressiveness of PTC. Different profiles of mutations were observed in conventional, follicular variants, and diffuse sclerosing variant of PTC, which might influence the different morphological appearances and clinical courses. In conclusion, molecular analysis can separate multifocal IP PTC from ITM PTC, and may be more important than tumor size in predicting lymph node metastasis, aggressiveness, and prognosis of PTC.

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Section: Discussionmentioning

confidence: 99%

Molecular analysis of multifocal papillary thyroid carcinoma

Lin¹,

Finkelstein²,

Zhu³

et al. 2008

Journal of Molecular Endocrinology

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“…Poor prognostic factors include age (N50 years), male sex, increased tumor size, lack of encapsulation, extrathyroidal extension, multicentricity, and distant metastases at presentation [1,11,23,36,37]. For some authors, a lymphocytic stroma reaction is associated with an improved prognosis [6,32].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and prognostic significance of tall cell variant of papillary thyroid carcinoma

et al. 2007

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“…Lymph node metastases were a risk factor for recurrence, and they were most numerous in the papillary type of carcinoma (Table 2), as described earlier (Mazzaferri & Jhiang 1994, Sclumberger 1998. In some, but not all, studies (Hay 1990, Mazzaferri & Jhiang 1994, local lymph node involvement has been associated with an increased risk of tumour recurrence and also with DTC-related mortality (Mazzaferri & Jhiang 1981, Mizukami et al 1992, Schlumberger & Pacini 1999. The prognostic impact of regional lymph node metastases still remains a controversial issue.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors in differentiated thyroid carcinomas and their implications for current staging classifications

Jukkola¹,

Bloigu²,

Ebeling³

et al. 2004

Endocr Relat Cancer

127

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Differentiated thyroid carcinomas (DTC) (papillary, follicular and follicular type of papillary) have a favourable prognosis, but a proportion of patients develop recurrences and eventually die of the disease. Various prognostic factors have been identified and been used to create the current staging classifications (AGES, AMES, MACIS, EORTC, UICC-TNM). We examined 499 DTC patients retrospectively to validate known prognostic factors that enable them to be recognised as having either a low or a high risk of death related to a recurrence of DTC, by reference to the current staging classifications. Sixty-nine of them (14%) had local or distant recurrences, the mean time to recurrence being 7.7 years. The 10-year disease-free survival rate was 80%, and the ten-year overall survival rate for the entire group was 91%, with a mean survival time of 8.7 years. Male gender, a follicular type of tumour, larger tumour size, extrathyroidal invasion outside the capsule and nodal metastases were all related to a higher incidence of tumour recurrence, and the follicular type of histology, age > 45 years, larger tumour size and local invasion entailed poorer survival. The AMES and to some extent the EORTC classification were not reproducible in this material, mainly because some prognostic variants were no longer encountered or were insufficient in number to allow reliable conclusions to be drawn. The MACIS staging classification leaves the definition of the intermediate and high risk groups too wide and is therefore not very reliable. Pooling of stages I and II improved the relevance of the TNM classification. All the current staging classifications are able to discern a low risk DTC group well. We achieved a highly accurate definition of risk in the present material using only two parameters, age (cut-off value 50 years) and extracapsular invasion of the thyroid gland.

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Papillary thyroid carcinoma in Kanazawa, Japan: prognostic significance of histological subtypes

Cited by 58 publications

References 30 publications

Molecular analysis of multifocal papillary thyroid carcinoma

Molecular analysis of multifocal papillary thyroid carcinoma

Prevalence and prognostic significance of tall cell variant of papillary thyroid carcinoma

Prognostic factors in differentiated thyroid carcinomas and their implications for current staging classifications

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