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

ObjectiveThe 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).MethodsThe tumour diameter was available in 324 out of 351 MSDS patients (244 females, 80 males). Mean age of patients was 47.7±12.0 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.ResultsThe 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 >2 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 >2 cm remained independent predictors of survival.ConclusionsIn 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.

Download Full-text

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

Acta Endocrinologica ◽

10.1530/eje-08-0805 ◽

2009 ◽

Vol 160 (4) ◽

pp. 619-624 ◽

Cited By ~ 37

Author(s):

Frederik A Verburg ◽

Uwe Mäder ◽

Markus Luster ◽

Christoph Reiners

Keyword(s):

Thyroid Carcinoma ◽

Cox Regression ◽

Tumour Size ◽

Retrospective Chart Review ◽

Distant Metastases ◽

Differentiated Thyroid Carcinoma ◽

Disease Stage ◽

Cancer Specific Survival ◽

Kaplan Meier ◽

Extrathyroidal Invasion

ObjectivePapillary 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.DesignRetrospective chart review study.PatientsThe 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.MethodsKaplan–Meier analyses and Cox-regression analyses were performed to assess the influence of histology on thyroid cancer-specific survival.ResultsFTC 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 (P=0.001) and the presence of extrathyroidal invasion (P=0.007), but not histology (P=0.26), were independent determinant variables for tumour-specific survival.ConclusionThere 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.

Download Full-text

Primary tumour diameter as a risk factor for advanced disease features of differentiated thyroid carcinoma

Clinical Endocrinology ◽

10.1111/j.1365-2265.2008.03482.x ◽

2009 ◽

Vol 71 (2) ◽

pp. 291-297 ◽

Cited By ~ 36

Author(s):

Frederik A. Verburg ◽

Uwe Mäder ◽

Markus Luster ◽

Christoph Reiners

Keyword(s):

Risk Factor ◽

Thyroid Carcinoma ◽

Advanced Disease ◽

Primary Tumour ◽

Differentiated Thyroid Carcinoma ◽

Tumour Diameter

Download Full-text

Solitary Liver Metastasis from Follicular Variant Papillary Thyroid Carcinoma: A Case Report

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v22i2.51768 ◽

2021 ◽

Vol 22 (2) ◽

pp. 146-149

Author(s):

Rahima Perveen ◽

Jasmin Ferdous ◽

Sharmin Quddus ◽

Tapati Mandal

Keyword(s):

Thyroid Cancer ◽

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Distant Metastases ◽

Differentiated Thyroid Carcinoma ◽

Papillary Thyroid ◽

Follicular Variant ◽

Thyroid Carcinomas ◽

Visceral Metastases ◽

Solitary Liver

Papillary and follicular thyroid carcinomas, together known as differentiated thyroid carcinomas (DTC), are among the most curable of cancers. Distant metastases are rare events at the onset of DTC. Sites of metastases from follicular thyroid cancer (FTC) are usually osseous, and those from papillary thyroid cancer (PTC) metastasize to regional nodal basins and the lungs. Visceral metastases are rare, but the involvement of multiple sites has been reported so far. Liver metastases from differentiated thyroid carcinoma (LMDTC) are rare.We present the case of a patient with follicular variant of papillary thyroid carcinoma (FVPTC) unusually involving the liver. Bangladesh J. Nuclear Med. 22(2): 146-149, Jul 2019

Download Full-text

Disease-free survival in papillary and follicular thyroid carcinoma

Nuklearmedizin ◽

10.3413/nukmed-0530-12-09 ◽

2013 ◽

Vol 52 (03) ◽

pp. 71-80 ◽

Cited By ~ 5

Author(s):

M. Meixner ◽

M. Hellmich ◽

M. Dietlein ◽

C. Kobe ◽

H. Schicha ◽

...

Keyword(s):

Lymph Node ◽

Thyroid Carcinoma ◽

Cervical Lymph Node ◽

Tumour Size ◽

Primary Tumour ◽

Disease Free Survival ◽

Distant Metastases ◽

Free Survival ◽

Explained Variation ◽

Disease Free

SummaryT stage was redefined for patients with differentiated thyroid carcinoma (DTC) between the 5th and 7th versions of the UICC tumour classification system. Patients, methods: 636 patients (486 women, 150 men; mean age 49.1 ± 15.6 years, mean follow-up 4.6 years) who had been treated with ablative radioiodine therapy after thyroidectomy for papillary (PTC) or follicular thyroid carcinomas (FTC) were retrospectively assessed on occurrence of locoregional recurrent disease, or cervical lymph node or distant metastases. Disease-free survival was calculated from initial T stage, classified according to both versions of the UICC staging system and compared with the prognostic value of primary tumour size. Kaplan-Meier method and two measures of explained variation, (1) R2 based on the (partial) likelihood ratio statistic of the Cox proportional hazards model and (2) a model-free variant of a distance measure proposed by Schemper had the aim to detect the most advantageous classification. Results: Of the 508 patients with PTC, 11 (2.2%) developed a local recurrence, 37 (7.3%) cervical lymph node and 23 (4.5%) distant metastases, 3 (2.3%), 8 (6.3%), and 18 (14.1%) were the numbers for the 128 FTC patients respectively. The two classification systems yielded an equal count of statistically significant differences regarding disease-free survival in patients with PTC while UICC 7th classification appeared slightly advantageous in patients with FTC. Regarding explained variation the UICC 7th classification tended to be superior to the UICC 5th classification, both in PTC and FTC, however statistical significance was not reached. Conclusion: The primary tumour size significantly added to the prognosis regarding local cervical and distant metastases.

Download Full-text

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

Yearbook of Endocrinology ◽

10.1016/j.yend.2011.05.003 ◽

2011 ◽

Vol 2011 ◽

pp. 157-159

Author(s):

M. Schott

Keyword(s):

Thyroid Carcinoma ◽

Tumour Size ◽

Primary Tumour ◽

Differentiated Thyroid Carcinoma ◽

Prognostic Parameter

Download Full-text

ОЦІНКА ПРОГНОЗУ МУЛЬТИФОКАЛЬНОЇ ВИСОКОДИФЕРЕНЦІЙОВАНОЇ ТИРЕОЇДНОЇ КАРЦИНОМИ ЗА СИСТЕМОЮ TNM

Medical Informatics and Engineering ◽

10.11603/mie.1996-1960.2016.3.6760 ◽

2016 ◽

Author(s):

N. Ya. Kobrynska

Keyword(s):

Comparative Analysis ◽

Thyroid Carcinoma ◽

Distant Metastases ◽

Differentiated Thyroid Carcinoma ◽

Thyroid Carcinomas ◽

Tnm System ◽

Multifocal Lesions ◽

Percent Difference ◽

T4 Stage ◽

The Difference

The comparative analysis of mono- and multifocal highly differentiated thyroid carcinoma (papillary and follicular) according to the TNM system was conducted. There were analyzed 2208 cases of monofocal and 692 cases of multifocal lesions in total. The analysis demonstrated that multifocal carcinomas, unlike solitary lesions, were characterized by a more aggressive course. Multicenter lesion by rubrics T, N and M with certainty at 99 % and more had higher indices than monofocal. Thus, T2 stage was recorded at 20.4 % of multifocal carcinomas versus 15.7 % for monofocal. The difference in T3 stage was also significant (22.4 % vs. 18.8 % respectively). In cases of T4 stage percent difference was 6.9 % with 5.0 % of multifocal and monofocal with thyroid carcinomas. N1a stage was recorded in 16.2 % of cases of multifocal carcinomas compared with 13.7 % for monofocal. Even more significant was the difference in N1b category - 15.7 % among multifocal that only 8.7 % of monofocal thyroid carcinomas. Distant metastases in patients with mono- and multifocal carcinoma were detected in isolated cases and this group of patients did not differ significantly from one another in such case (p > 0.05). The main conclusion is the need for more radical tactics of treatment in these cases.

Download Full-text

Clinicoradiological characteristics of patients with differentiated thyroid carcinoma and renal metastasis: case series with follow up

The Journal of Laryngology & Otology ◽

10.1017/s0022215113003617 ◽

2014 ◽

Vol 128 (2) ◽

pp. 203-208 ◽

Cited By ~ 5

Author(s):

P Kand ◽

S Basu

Keyword(s):

Thyroid Carcinoma ◽

Primary Tumour ◽

Case Series ◽

Distant Metastases ◽

Needle Aspiration ◽

Differentiated Thyroid Carcinoma ◽

Flip Flop ◽

Renal Metastasis ◽

Positron Emission

AbstractBackground:Renal metastasis is relatively unusual in patients with differentiated thyroid carcinoma.Methods:The clinicoradiological parameters of a series of patients with differentiated thyroid carcinoma and renal metastasis were assessed, together with follow-up data.Results and conclusion:The series comprised 4 male patients over the age of 45 years with extensive disease at the primary site. Retro-sternal extension of a large goitre was observed in three patients. The primary tumour was 4 cm or larger in all patients (range, 4–14 cm), and three patients had associated lymph node metastasis. None had any genito-urinary symptoms at presentation. Two patients had isolated renal metastases with no other distant metastases, while the others had extensive multi-organ involvement. The bilateral occurrence of lesions was a hallmark, being observed in all cases. Ultrasound-guided fine needle aspiration cytology and 131I scintigraphy were pivotal in confirming the diagnosis. Evidence of ‘flip-flop’ between 131I study and fluoro-deoxyglucose positron emission tomography was noted in one patient, while the other three demonstrated concordant lesions in both modalities. At a minimum follow-up period of four years after diagnosis, three patients demonstrated stable disease with radioiodine therapy, and one had expired due to a poorly differentiated lung carcinoma which developed subsequently.

Download Full-text

Neoadjuvant chemotherapy in 13 patients with locally advanced poorly differentiated thyroid carcinoma based on Turin proposal - a single institution experience

Radiology and Oncology ◽

10.1515/raon-2015-0001 ◽

2015 ◽

Vol 49 (3) ◽

pp. 271-278 ◽

Cited By ~ 4

Author(s):

Nikola Besic ◽

Marta Dremelj ◽

Andreja Schwartzbartl-Pevec ◽

Barbara Gazic

Keyword(s):

Neoadjuvant Chemotherapy ◽

Thyroid Carcinoma ◽

Primary Tumour ◽

Locally Advanced ◽

Differentiated Thyroid Carcinoma ◽

Tumour Regression ◽

External Beam Irradiation ◽

Poorly Differentiated Thyroid Carcinoma ◽

Tumour Diameter ◽

Poorly Differentiated

AbstractBackground.There is a paradigm that chemotherapy is ineffective in thyroid carcinoma. The aim of our study was to find out whether neoadjuvant chemotherapy before thyroid surgery had an effect on the size of primary tumour in patients with poorly differentiated thyroid carcinoma (PDTC) based on Turin proposal.Patients and methods.Altogether, 13 patients (8 women, 5 men; median age 61 years) with PDTC based on Turin proposal were treated with neoadjuvant chemotherapy between 1986 and 2005. Tumour diameter was from 4.5 to 18 cm (median 9 cm). Regional and distant metastases were detected in 6 and 9 patients, respectively. Eight patients had pT4 tumour.Results.Altogether, 29 (range 1–5) cycles of chemotherapy were given. Tumour diameter decreased in all the patients and by more than 30% in 5 patients (= 38%). Two of these five patients had also preoperative external beam irradiation (EBRT). Total thyroidectomy, lobectomy and neck dissection were performed in 10, 3 and 5 cases, respectively. R0 and R1 resection was done in 5 and 8 cases, respectively. Eight patients had postoperative EBRT of the neck and upper mediastinum. The 5-year and 10-year cause-specific survival rates of patients were 66% and 20%, respectively.Conclusions.After neoadjuvant chemotherapy a partial tumour regression was observed in 38% of patients with PDTC based on Turin proposal.

Download Full-text

Synchronous intrathyroidal parathyroid carcinoma and thyroid carcinoma: case report and review of the literature

BMC Endocrine Disorders ◽

10.1186/s12902-021-00724-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nadia De Falco ◽

Giuseppe Santangelo ◽

Fabrizio Chirico ◽

Angelo Cangiano ◽

Maria Giulia Sommella ◽

...

Keyword(s):

Literature Review ◽

Thyroid Carcinoma ◽

Papillary Carcinoma ◽

Parathyroid Carcinoma ◽

Malignant Tumors ◽

Gamma Probe ◽

Differentiated Thyroid Carcinoma ◽

Thyroid Carcinomas ◽

First Case ◽

Well Differentiated

Abstract Background Parathyroid carcinoma is a rare endocrine malignancy, rarer when synchronous with a non medullary well differentiated thyroid carcinoma. Parathyroid carcinoma accounts of 0.005% of all malignant tumors and it is responsible for less than 1% of primary hyperparathyroidism. The intrathyroidal localization of a parathyroid gland is not frequent with a reported prevalence of 0.2%. Carcinoma of parathyroids with intrathyroidal localization represents an even rarer finding, reported in only 16 cases described in literature. The rare constellation of synchronous parathyroid and thyroid carcinomas has prompted us to report our experience and perform literature review. Case presentation We herein report a case of a 63-years-old man with multinodular goiter and biochemical diagnosis of hyperparathyroidism. Total thyroidectomy with radio-guide technique using gamma probe after intraoperative sesta-MIBI administration and intraoperative PTH level was performed. The high radiation levels in the posterior thyroid lobe discovered an intrathyroidal parathyroid. Microscopic examination revealed a parathyroid main cell carcinoma at the posterior thyroidal left basal lobe, a classic papillary carcinoma at the same lobe and follicular variant of papillary carcinoma at the thyroidal right lobe. To the best of our knowledge, this is the first case documenting a synchronous multicentric non medullary thyroid carcinomas and intrathyroidal parathyroid carcinoma. Conclusions Our experience was reported and literature review underlining challenging difficulties in diagnostic workup and surgical management was carried out.

Download Full-text