Propensity score matching analysis of the prognosis for the rare oxyphilic subtype of thyroid cancer (Hurthle cell carcinoma)

Xiong, Yiquan; Zhao, Qiu; Li, Zhi; Wang, Shuntao; Guo, Hui; Liu, Zeming; Huang, Tao

doi:10.18632/oncotarget.20732

Cited by 11 publications

(7 citation statements)

References 28 publications

(22 reference statements)

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“…More importantly, that study also failed to incorporate propensity-score matching in order to minimize the effect of potentially confounding factors. In contrast, the SEER database includes patient data from diverse geographical regions and is considered the gold-standard database for tumor surveillance and related analysis in the US, as it contains data from approximately 10% of the American patient population [18]. Therefore, the present study provides greater clarity regarding the prognostic implications of the magnitude of ETE among patients with differentiated thyroid cancer.…”

Section: Discussionmentioning

confidence: 99%

Minimal extrathyroidal extension affects the prognosis of differentiated thyroid cancer: Is there a need for change in the AJCC classification system?

et al. 2019

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Minimal extrathyroidal extension (ETE) is defined as tumor cells extending to the sternothyroid muscle or perithyroidal soft tissue. However, there is controversy regarding whether the magnitude of ETE (minimal or gross) should be considered in assigning a precise TNM stage to patients with thyroid cancer in the seventh/eighth editions of the AJCC system. The present study evaluated Surveillance, Epidemiology, and End Results data from 107,114 patients with differentiated thyroid cancer (2004–2013) to determine whether the magnitude of ETE (thyroid confinement, minimal, or gross) influenced the ability to predict cancer-specific survival (CSS) and overall survival (OS). Patient mortality was evaluated using Cox proportional hazards regression analyses and Kaplan-Meier analyses with log-rank tests. The cancer-specific mortality rates per 1,000 person-years were 1.407 for the thyroid confinement group (95% CI: 1.288–1.536), 5.133 for the minimal ETE group (95% CI: 4.301–6.124), and 29.735 for the gross ETE group (95% CI: 28.147–31.412). Relative to the thyroid confinement group, patients with minimal ETE and gross ETE had significantly poorer CSS and OS in the univariate and multivariate analyses (both P<0.001). After propensity-score matching according to age, sex, and race, we found that thyroid confinement was associated with better CSS and OS rates than minimal ETE (P<0.001) and gross ETE (P<0.001). These results from a population-based cohort provide a reference for precise personalized treatment and management of patients with minimal ETE. Furthermore, it may be prudent to revisit the magnitude of ETE as advocated by the AJCC and currently used for treatment recommendation by the American Thyroid Association.

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Section: Discussionmentioning

confidence: 99%

Minimal extrathyroidal extension affects the prognosis of differentiated thyroid cancer: Is there a need for change in the AJCC classification system?

et al. 2019

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“…Although Hürthle cell histology is an independent risk factor for reduced 10 year survival, patients with HCC had an unusually good prognosis compared with papillary or follicular carcinoma, even after adjustment for age, type of curative treatment, extrathyroidal extension, nodal or distant metastases [6,7].…”

Section: Discussionmentioning

confidence: 97%

Young age - an unusual finding of Hurthle cell carcinoma

Teodoriu¹,

Ciobanu-Apostol²,

Grigorovici³

et al. 2018

Arch Clin Cases

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Hürthle cell carcinoma is a rare thyroid neoplasm which originates from the follicular epithelium of the thyroid gland and is considered a true rarity in young patients. A 30 year-old woman was admitted to our department with palpable anterior cervical mass due to enlarged thyroid. The ultrasound revealed a large thyroid nodule with central hypoechogenicity, peripheral hyperechogenicity and positive Doppler signal. The patient had no distinguishable lateral cervical lymphadenopathy. The TI-RADS calculation (thyroid image reporting data system) classified the nodule as TR4 (4 points), which indicated a fine needle aspiration biopsy (FNAB), declined by the patient. Total thyroidectomy was performed and the histological findings associated with immunohistochemical study revealed the diagnosis of Hürthle cell carcinoma with capsular and vascular invasion. Because the microscopic vascular invasion was < 4 foci the patient was classified as low-risk group. Even so, due to the young age she was referred to radioactive iodine therapy for completion of curative treatment. This case illustrates the difficulties in the management of thyroid nodules with suspicious features on ultrasound, in the absence of FNAB exploration, and the unusual presence of Hürthle cell carcinoma in a young age patient, knowing the 6 th decade is the average age for this rare type of thyroid neoplasm.

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“…The clinical outcome of OFTC is still discussed controversially. In fact, four different US studies which searched for the same outcome and were performed on the same Surveillance, Epidemiology, and End Results (SEER) database came to different results [ 5 , 6 , 28 , 29 ]. Thus, the prognosis of OFTC in comparison with classical FTC still needs to be studied.…”

Section: Discussionmentioning

confidence: 99%

“…All our patients were treated with total or near total thyroidectomy followed by initial RIT. In previously published studies, the percentage of thyroidectomy ranged from 27 to 100% [ 6 , 11 , 13 , 17 , 18 , 28 , 30 – 32 , 34 ]. Surgery for thyroid carcinoma is an important component of a multimodal treatment approach.…”

Section: Discussionmentioning

confidence: 99%

Clinical impact of follicular oncocytic (Hürthle cell) carcinoma in comparison with corresponding classical follicular thyroid carcinoma

Wenter

Albert

Ahmaddy

et al. 2020

Eur J Nucl Med Mol Imaging

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Purpose There are controversial debates if patients with Hürthle cell carcinoma, also known as oxyphilic or oncocytic cell follicular thyroid carcinoma, have a poorer outcome. In this study, we systematically evaluated the clinical outcome in a large patient cohort following thyroidectomy and initial I-131 radioactive iodine therapy (RIT). Methods We retrospectively evaluated a total of 378 patients with diagnosed oncocytic follicular Hürthle cell carcinoma (OFTC) (N = 126) or with classical follicular thyroid carcinoma (FTC) (N = 252). Patients received thyroidectomy and complementary I-131 RIT. Clinical data regarding basic demographic characteristics, tumor grade, persistent disease and recurrence during followup, and disease-free, disease-specific, and overall survival were collected during follow-up of 6.9 years (interquartile range 3.7; 11.7 years). Univariate and multivariate analyses were used to identify factors associated with disease-related and overall survival. Results Before and after matching for risk factors, recurrence was significantly more frequently diagnosed in OFTC patients during follow-up (17% vs. 8%; p value 0.037). Likewise, OFTC patients presented with a reduced mean disease-free survival of 17.9 years (95% CI 16.0-19.8) vs. 20.1 years (95% CI 19.0-21.1) in FTC patients (p value 0.027). Multivariate analysis revealed OFTC (HR 0.502; 95% CI 0.309-0.816) as the only independent prognostic factor for disease-free survival. Distant metastases of OFTC patients were significantly less iodine-avid (p value 0.014). Mean disease-specific and overall survival did not differ significantly (p value 0.671 and 0.687) during follow-up of median 6.9 years (3.7; 11.7 years). Conclusions Our study suggests that recurrence is more often seen in OFTC patients. OFTC patients have a poorer prognosis for disease-free survival. Thus, OFTC and FTC behave differently and should be categorized separately. However, patients suffering from OFTC present with the same overall and disease-specific survival at the end of follow-up indifferent to FTC patients after initial RIT.

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Propensity score matching analysis of the prognosis for the rare oxyphilic subtype of thyroid cancer (Hurthle cell carcinoma)

Cited by 11 publications

References 28 publications

Minimal extrathyroidal extension affects the prognosis of differentiated thyroid cancer: Is there a need for change in the AJCC classification system?

Minimal extrathyroidal extension affects the prognosis of differentiated thyroid cancer: Is there a need for change in the AJCC classification system?

Young age - an unusual finding of Hurthle cell carcinoma

Clinical impact of follicular oncocytic (Hürthle cell) carcinoma in comparison with corresponding classical follicular thyroid carcinoma

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