Prognostic factors in papillary carcinoma of the thyroid

Schindler, Alan M.; Melle, Guy van; Evequoz, Beatrice; Scazziga, B

doi:10.1002/1097-0142(19910715)68:2<324::aid-cncr2820680220>3.0.co;2-s

Cited by 84 publications

(47 citation statements)

References 35 publications

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“…Multifocality also frequently exhibits in PTC. Certain studies have indicated that multifocal carcinoma in PTC is positively associated with the incidence of CLNM [14,15], while other studies have argued that there is no association between multifocality and CLNM [16]. In addition, multifocality has found to significantly increase the incidence of recurrence [17].…”

mentioning

confidence: 99%

The synergic effect of BRAF<sup>V600E</sup> mutation and multifocality on central lymph node metastasis in unilateral papillary thyroid carcinoma

Qu¹,

Hu³

et al. 2018

Endocr J

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Abstract. The purpose of this study is to evaluate the potential synergic effect of BRAF V600E mutation and multifocality on central lymph nodes metastasis (CLNM) in the patients with unilateral papillary thyroid carcinoma (PTC). We enrolled 413 patients with unilateral PTCs who accepted prophylactic unilateral or bilateral central lymph node dissection (LND). Univariate and multivariate analyses were made to determine the association between related factors and CLNM. Then, all patients were divided into 4 groups based on their status of BRAF V600E mutation and multifocality. Relative excess risk of interaction (RERI), attributable proportion (AP) of interaction and synergy index (SI) were applied to evaluate the interactive effect of these two factors on CLNM. Results showed that BRAF V600E mutation and multifocality were independent risk factors for CLNM. A further study revealed that unilateral PTCs accompanying multifocality with BRAF V600E mutation had the highest incidence of CLNM compared with other subgroups. Besides, RERI was 4.323 (95% CI = 1.276-7.369), AP was 0.523 (95% CI = 0.364-0.682) and SI was 2.469 (95% CI = 1.607 to 3.794), indicating a significant additive interaction of BRAF V600E mutation and multifocality on CLNM. The present study has confirmed that BRAF V600E mutation and multifocality are risk factors for CLNM in unilateral PTC. Additionally, unilateral PTC patients accompanying multifocality with BRAF V600E mutation may have an increased risk of CLNM in clinically negative CLNM.

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mentioning

confidence: 99%

The synergic effect of BRAF<sup>V600E</sup> mutation and multifocality on central lymph node metastasis in unilateral papillary thyroid carcinoma

Qu¹,

Hu³

et al. 2018

Endocr J

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“…In addition, certain pathological features such as marked nuclear atypia, necrosis or vascular invasion are also important (Tennvall et al, 1985;Schindler et al, 1991;Akslen et al, 1993). This information may improve the risk estimation for individual patients.…”

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confidence: 99%

Prognostic impact of EGF-receptor in papillary thyroid carcinoma

Akslen¹,

Myking²,

Salvesen³

et al. 1993

Br J Cancer

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Summary In this study of papillary thyroid carcinomas, immunopositivity for EGF-receptor was present in a majority of the cases (96%), although different staining patterns were observed. A distinct membraneous reaction was found in 46%, whereas cytoplasmatic positivity of various degrees was present in 90% of the cases. Strong cytoplasmic EGF-receptor staining was significantly associated with extra-thyroidal growth of the primary tumour (P = 0.009), and it was furthermore related to decreased recurrence free survival (P = 0.006). Membraneous EGF-receptor staining was not associated with recurrence free survival or patient survival. Multivariate Cox analysis showed that lymph node metastases (P = 0.0009) and cytoplasmic EGFreceptor staining (P = 0.0048) was independent indicators of tumour recurrences in this group of surgically treated papillary thyroid carcinomas.The prognosis of patients with papillary thyroid carcinoma has previously been described in several reports (Byar et al., 1979; Tubiana et al., 1985;Carcangiu et al., 1985;Akslen et al., 1991), and the influence of sex, age and tumour stage has been discussed. In addition, certain pathological features such as marked nuclear atypia, necrosis or vascular invasion are also important (Tennvall et al., 1985;Schindler et al., 1991;Akslen et al., 1993). This information may improve the risk estimation for individual patients.In recent years, alterations in various growth factors and their receptors have been established as important features of the neoplastic process (Wynford-Thomas, 1991), among them epidermal growth factor (EGF) and its receptor (EGF-R). EGF is known to induce cell proliferation in several tissues, and its effect is mediated via a tyrosine kinase type of receptor (Carpenter & Cohen, 1979). It has previously been shown by different methods that EGF-receptors are expressed in papillary thyroid carcinomas (Duh et al., 1985;Lemoine et al., 1991;Mizukami et al., 1991; Mizukami et al., 1992), but the biological significance of this finding in terms of patient prognosis is not known. The purpose of the present study was therefore to perform a retrospective immunohistochemical study of EGF-R expression in a series of papillary thyroid carcinomas with special reference to its prognostic importance. Material and methodsPatients This material has been described previously . Briefly, all 263 patients who were surgically treated for thyroid cancer at the Department of Surgery, Haukeland Hospital, University of Bergen in the period 1971-1985 have been studied retrospectively. After histological revision and subtyping of the carcinomas according to the WHO criteria (Hedinger, 1988), 173 cases were found to be papillary carcinomas with a known primary tumour. One of the main results from our previous study was that very few events were observed in tumours with a diameter of 10 mm or below (microcarcinomas according to the WHO criteria). These were therefore excluded, thereby concentrating on clinically significant papillary carcinomas. Sufficient materia...

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“…Moreover, it was proposed that different staging systems should be evaluated and validated independently for PTC and FTC [Lang et al, 2007a]. Finally, PTMCs are excluded from some studies [Schindler et al, 1991].…”

Section: Staging Systemsmentioning

confidence: 99%

Papillary Thyroid Microcarcinoma - Do Classical Staging Systems Need to Be Changed?

Zafón¹

2012

Thyroid and Parathyroid Diseases - New Insights Into Some Old and Some New Issues

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Prognostic factors in papillary carcinoma of the thyroid

Cited by 84 publications

References 35 publications

The synergic effect of BRAF<sup>V600E</sup> mutation and multifocality on central lymph node metastasis in unilateral papillary thyroid carcinoma

The synergic effect of BRAF<sup>V600E</sup> mutation and multifocality on central lymph node metastasis in unilateral papillary thyroid carcinoma

Prognostic impact of EGF-receptor in papillary thyroid carcinoma

Papillary Thyroid Microcarcinoma - Do Classical Staging Systems Need to Be Changed?

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