Patterns of care for patients with primary differentiated carcinoma of the thyroid gland treated in Germany during 1996

H�lzer, Simon; Reiners, C.; Mann, Klaus; Bamberg, M.; Rothmund, M.; Dudeck, Joachim; Stewart, Andrew K.; Hundahl, Scott A.

doi:10.1002/1097-0142(20000701)89:1<192::aid-cncr26>3.0.co;2-7

Cited by 78 publications

(46 citation statements)

References 20 publications

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“…North American endocrinologists rely heavily on FNAB results; however, European endocrinologists, especially French ones, perform supplementary testing such as US, and will opt for surgery in cases where there are clinical or US features favouring thyroid malignancies despite benign FNAB results (16,17). These results are in accordance with the study of Hölzer et al (18) on the current patterns of care and disease characteristics for patients with thyroid carcinoma where FNAB of the thyroid is highly recommended in the current Clinical Practice Guidelines available in Germany but FNAB was performed in only 27.4% of the patients. These results emphasized the fact that diagnosis of thyroid carcinoma is often derived from a combination of US, thyroid scan or FNAB, together with clinical findings.…”

Section: Discussionsupporting

confidence: 77%

Advances in diagnostic practices affect thyroid cancer incidence in France

Leenhardt

Bernier

Boin-Pineau

et al. 2004

European Journal of Endocrinology

204

112

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Objective: To analyse trends in diagnostic practices of thyroid diseases and to relate them to the increase in thyroid cancer incidence in France over time. Design: From 1980 to 2000, a French retrospective multicentric (three endocrinology and three nuclear medicine centres) study of thyroid diseases was conducted on 20 consecutive unselected patients' records, sampled every 5 years in each centre. Methods: Characteristics of the population and diagnosis procedures (thyroid ultrasonography (US), radionuclide scan, cytology and hormonal measurements) were described over time. Changing trends in operated patients and in cancer prevalence were analysed as well as the impact of practices on cancer incidence. Results: The study included 471 patients (82% female, mean age 46.7, range 9-84 years), referred for nodular thyroid diseases (66.7%) or thyroid dysfunctions (33.3%). A significant increase in US (3 to 84.8%) and cytological practices (4.5 to 23%), and a decrease (89.4 to 49.6%) in radionuclide scan procedures were observed over time. Although the proportion of patients undergoing surgery remained constant (24.8%), the prevalence of cancer increased among operated patients from 12.5 to 37% (P ¼ 0.006). In a Cox's proportional hazard model stratified on the clinical characteristics of patients, only the cytological practice, regardless of its results, was significantly associated with the occurrence of cancer: relative risk (RR) ¼ 4.4 (95% confidence interval (CI): 1

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Section: Discussionsupporting

confidence: 77%

Advances in diagnostic practices affect thyroid cancer incidence in France

Leenhardt

Bernier

Boin-Pineau

et al. 2004

European Journal of Endocrinology

204

112

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“…FTC patients present with a larger diameter of the primary tumour and more often have distant metastases at the time of initial presentation (1,2,8,9), both of which are considered indicators of poor prognosis with regard to recurrence-free and thyroid cancer-specific survival. On the other hand FTC only infrequently shows lymph node metastases, contrary to PTC (2,10).…”

Section: Introductionmentioning

confidence: 99%

Histology does not influence prognosis in differentiated thyroid carcinoma when accounting for age, tumour diameter, invasive growth and metastases

Verburg¹,

Mäder²,

Luster³

et al. 2009

European Journal of Endocrinology

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Objective: Papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) show considerable differences in disease stage at initial presentation. The aim of this study was to investigate whether there are differences in tumour-specific survival if initial staging is accounted for. Design: Retrospective chart review study. Patients: The study sample comprised 875 PTC and 350 FTC patients (856 females, 369 males, mean age 47.8 years) treated in our hospital from 1978 to 2002. All patients received total thyroidectomy with subsequent I-131 ablation except for those patients with an isolated papillary microcarcinoma. Methods: Kaplan-Meier analyses and Cox-regression analyses were performed to assess the influence of histology on thyroid cancer-specific survival. Results: FTC patients were on average older, more likely to be male, presented with a larger tumour and more frequently had multifocal carcinoma and distant metastases than PTC patients, whereas they presented less frequently with extrathyroidal invasion or lymph node metastases. Twenty-year tumour-specific survival in PTC was 90.6% and in FTC 73.7% (P!0.001). In multivariate analysis the presence of distant metastases (P!0.001), age (P!0.001), tumour size (PZ0.001) and the presence of extrathyroidal invasion (PZ0.007), but not histology (PZ0.26), were independent determinant variables for tumour-specific survival. Conclusion: There is no difference in tumour-specific survival between PTC and FTC when accounting for the presence of metastases, age, tumour size and the presence of extrathyroidal invasion.

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“…This is not the case in large international epidemiological studies, which have relied on pathology reports with no review of tissue specimens (Hundahl et al, 1998;Holzer et al, 2000;Hundahl et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Histological validation of diagnoses of thyroid cancer among adults in the registries of Belarus and the Ukraine

Franc

Valenty

Galakhin³

et al. 2003

Br J Cancer

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In order to evaluate the diagnostic reliability of the thyroid cancers listed in adult registries from the Ukraine and Belarus, a histological review was organised of 327 randomly selected thyroid carcinoma cases diagnosed between 1980 and 1999. A final diagnosis was reached at a 5-day consensus conference by six pathologists who met around a multiheaded microscope. The study concluded with a comparison between the final diagnosis and the initial diagnosis. The pathologists agreed with the initial diagnosis of malignancy in 286 cases (88%). A final diagnosis of papillary, follicular or medullary thyroid carcinoma was reached in 86, 4, and 6% of the cases respectively. In 2.8% of the cases reviewed, diagnostic discrepancies persisted. The percentage of agreement between the final diagnosis and the initial diagnosis was 93%, with a weighted k-statistic of 0.61 (confidence interval 95% (CI 95% ): [0.45 -0.77]). In all, 89% of the 286 confirmed cancer cases were in agreement for the type of cancer, with a k-statistic of 0.56 (CI 95% : [0.43 -0.69]). The level of agreement differed according to cancer categories, with concordance rates of 94, 40 and 33% for papillary, follicular and medullary thyroid carcinomas respectively. The low prevalence of follicular thyroid carcinomas in the adult population studied calls for further exploration. The discrepancies and classification difficulties encountered were analysed.

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Patterns of care for patients with primary differentiated carcinoma of the thyroid gland treated in Germany during 1996

Cited by 78 publications

References 20 publications

Advances in diagnostic practices affect thyroid cancer incidence in France

Advances in diagnostic practices affect thyroid cancer incidence in France

Histology does not influence prognosis in differentiated thyroid carcinoma when accounting for age, tumour diameter, invasive growth and metastases

Histological validation of diagnoses of thyroid cancer among adults in the registries of Belarus and the Ukraine

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