Primary tumour size is a prognostic parameter in patients suffering from differentiated thyroid carcinoma with extrathyroidal growth: results of the MSDS trial

Abstract

Objective: The Multicentre Study Differentiated Thyroid Cancer (MSDS) collective represents a well-defined group of patients with thyroid carcinomas with extrathyroidal extension. The aim of the present study was to evaluate the relationship of the primary tumour size with clinicopathological features as well as the outcome of patients with minimum and extensive extrathyroidal growth (pT3b-and pT4a-tumours; UICC 2002/2003, 6th ed). Methods: The tumour diameter was available in 324 out of 351 MSDS patients (244 females, 80 males). Mean age of patients was 47.7G12.0 years (range, 20.1-69.8 years), and the median follow-up was 6.2 years. The relationship between primary tumour size and the following clinicopathological data was investigated: age, gender, histological tumour type (papillary thyroid carcinomas (PTC) versus follicular thyroid carcinomas (FTC)) and UICC/AJCC TNM classification. In addition, the correlation between primary tumour size and event-free and overall survival was assessed. Results: The FTC of our series were significantly larger than PTC (3.46 vs 1.84 cm; P!0.001). Patients suffering from pT3b-tumours presented with significantly smaller tumour size than those with extensive extrathyroidal growth (pT4a-tumours) (1.9 vs 3.0 cm; P!0.01). All patients with distant metastases suffered from tumours O2 cm. Furthermore, event-free and overall survival were significantly correlated with increasing tumour size (P!0.05). Using multivariate analysis, a pT4a-category and a tumour diameter O2 cm remained independent predictors of survival. Conclusions: In patients suffering from differentiated thyroid carcinoma with extrathyroidal growth (pT3b and pT4a), the tumour size is an independent predictor of event-free and overall survival.

Characteristics and significance of minimal and maximal extrathyroidal extension in papillary thyroid carcinoma

“…The prevalence of ETE in PTC varies from 5% to 55.3%, and larger tumors are associated with an increased likelihood of ETE [1,3,18,[20][21][22]. In the present study, ETE was found in 49.2% (minimal ETE 41.7%, maximal ETE 7.5%) of patients with PTC, which is comparable to findings in other studies.…”

Clinicopathological, immunohistochemical factors and recurrence associated with extrathyroidal extension in papillary thyroid microcarcinoma

“…[14,15] The reported prevalence of PTC with ETE varies, ranging from 2 to 45%, with progressively bigger tumors in PTC being associated with increased likelihood of ETE. [1,[3][4][5]7,8,[16][17][18] Similarly, an increasing number of studies support the present finding that PTMC displays evidence of ETE and/or nodal metastasis. [19][20][21][22] The prevalence of ETE in PTMC is similar to PTC, ranging from 2 to 52% and the increasing frequency of ETE is accompanied by the increasing tumor size in PTMC, as in PTC.…”

“…[19][20][21][22] The prevalence of ETE in PTMC is similar to PTC, ranging from 2 to 52% and the increasing frequency of ETE is accompanied by the increasing tumor size in PTMC, as in PTC. [9,12,18,[23][24][25][26][27][28][29][30] In this study, the prevalence was 28.0% (91/325) and the frequency of ETE also increased with increasing tumor size. The collective observations suggest that PTMC may be an early-detected form of PTC, rather than a different disease entity, which may have been described previously as an indolent tumor.…”

Clinical Utility of 18F-FDG PET/CT Concurrent with 131I Therapy in Intermediate–to–High-Risk Patients with Differentiated Thyroid Cancer: Dual-Center Experience with 286 Patients

“…Recurrence is found in 16%-35% of DTC patients after initial surgery (19,20), and recurrent DTC cells often exhibit negative 131 I uptake and positive findings on 18 F-FDG PET/CT due to cell dedifferentiation (6,21). Furthermore, T stage, presence of nodal metastasis, and tumor size are prognostic factors for DTC that reflect the aggressiveness of cancer cells (16,17,22,23). A previous study has already shown that glucose transporter 1 expression increased with escalating dedifferentiation and aggressiveness of thyroid cancer cells (24).…”