Differential clinicopathological risk and prognosis of major papillary thyroid cancer variants

Differential clinicopathological risk and prognosis of major papillary thyroid cancer variants

Author Shi, Xiaoguang Google Scholar
Liu, Rengyun Google Scholar
Basolo, Fulvio Google Scholar
Giannini, Riccardo Google Scholar
Shen, Xiaopei Google Scholar
Teng, Di Google Scholar
Guan, Haixia Google Scholar
Shan, Zhongyan Google Scholar
Teng, Weiping Google Scholar
Musholt, Thomas J. Google Scholar
Al-Kuraya, Khawla Google Scholar
Fugazzola, Laura Google Scholar
Colombo, Carla Google Scholar
Kebebew, Electron Google Scholar
Jarzab, Barbara Google Scholar
Czarniecka, Agnieszka Google Scholar
Bendlova, Bela Google Scholar
Sykorova, Vlasta Google Scholar
Sobrinho-Simoes, Manuel Google Scholar
Soares, Paula Google Scholar
Shong, Young Kee Google Scholar
Kim, Tae Yong Google Scholar
Cheng, Sonia Google Scholar
Asa, Sylvia L. Google Scholar
Viola, David Google Scholar
Elisei, Rossella Google Scholar
Yip, Linwah Google Scholar
Mian, Caterina Google Scholar
Vianello, Federica Google Scholar
Wang, Yangang Google Scholar
Zhao, Shihua Google Scholar
Oler, Gisele Autor UNIFESP Google Scholar
Cerutti, Janete Maria Autor UNIFESP Google Scholar
Puxeddu, Efisio Google Scholar
Qu, Shen Google Scholar
Wei, Qing Google Scholar
Xu, Huixiong Google Scholar
O'Neill, Christine J. Google Scholar
Sywak, Mark S. Google Scholar
Clifton-Bligh, Roderick Google Scholar
Lam, Alfred K. Google Scholar
Riesco-Eizaguirre, Garcilaso Google Scholar
Santisteban, Pilar Google Scholar
Yu, Hongyu Google Scholar
Tallini, Giovanni Google Scholar
Holt, Elizabeth H. Google Scholar
Vasko, Vasily Google Scholar
Xing, Mingzhao Google Scholar
Abstract Context: Individualized management, incorporating papillary thyroid cancer (PTC) variant-specific risk, is conceivably a useful treatment strategy for PTC, which awaits comprehensive data demonstrating differential risks of PTC variants to support. Objective: This study sought to establish the differential clinicopathological risk of major PTC variants: conventional PTC (CPTC), follicular-variant PTC (FVPTC), and tall-cell PTC (TCPTC). Methods: This was a retrospective study of clinicopathological outcomes of 6282 PTC patients (4799 females and 1483 males) from 26 centers and The Cancer Genome Atlas in 14 countries with a median age of 44 years (interquartile range, 33-56 y) and median follow-up time of 37 months (interquartile range, 15-82 mo). Results: The cohort consisted of 4702 (74.8%) patients with CPTC, 1126 (17.9%) with FVPTC, and 239 (3.8%) with TCPTC. The prevalence of high-risk parameters was significantly different among the three variants, including extrathyroidal invasion, lymph node metastasis, stages III/IV, disease recurrence, mortality, and the use (need) of radioiodine treatment (all P < .001), being highest in TCPTC, lowest in FVPTC, and intermediate in CPTC, following an order of TCPTC > CPTC >> FVPTC. Recurrence and mortality in TCPTC, CPTC, and FVPTC were 27.3 and 6.7%, 16.1 and 2.5%, and 9.1 and 0.6%, corresponding to events per 1000 person-years (95% confidence interval [CI]) of 92.47 (64.66-132.26) and 24.61 (12.31-49.21), 34.46 (30.71-38.66), and 5.87 (4.37-7.88), and 24.73 (18.34-33.35) and 1.68 (0.54-5.21), respectively. Mortality hazard ratios of CPTC and TCPTC over FVPTC were 3.44 (95% CI, 1.07-11.11) and 14.96 (95% CI, 3.93-56.89), respectively. Kaplan-Meier survival analyses showed the best prognosis in FVPTC, worst in TCPTC, and intermediate in CPTC in disease recurrence-free probability and disease-specific patient survival. This was particularly the case in patients at least 45 years old. Conclusion: This large multicenter study demonstrates differential prognostic risks of the three major PTC variants and establishes a unique risk order of TCPTC > CPTC >> FVPTC, providing important clinical implications for specific variant-based management of PTC.
Keywords Braf V600e Mutation
Tall-Cell Variant
Needle-Aspiration Biopsy
Follicular Variant
Braf(V600e) Mutation
Language English
Sponsor US National Institutes of Health (NIH) [RO1CA113507, R01CA189224]
National Science Centre Poland (Poland) [N403 194340, N N401 612440, 267398]
Queensland Government (Australia)
Griffith Health Institute (Australia)
Fondazione Cassa di Risparmio di Perugia (Italy)
Associazione Italiana per la Ricerca sul Cancro (Italy) [IG 9338]
Beadle Family Foundation (San Antonio, TX)
New South Wales Cancer Institute (Australia)
Cancer Council of New South Wales (Australia)
Italian Government-Ministero della Salute (Italy) [RF-2011-02350857]
Ministerodella Istruzione Universitaria e Ricerca Scientifica (Italy)
AssociazioneItaliana per la Ricerca sul Cancro (Italy)
Istituto Toscano Tumori (Italy)
Ministero della Salute (Italy)
Korean Foundation for Cancer Research (South Korea) [CB-2011-03-02]
Sao Paulo State Research Foundation (FAPESP) [2012/02902-9, 2013/03867-5]
AIRC (Italy) [IG 10316]
Shanghai Hospital Development Center (China) [SHDC 12014229]
Programa Operacional Regional do Norte (ON.2-O Novo Norte), under the Quadro de Referencia Estrategico Nacional
Fundo Europeu de Desenvolvimento Regional
[RD12/0036/0030 FIS-ISCIII]
[S2011/BMD-2328 TIRONET]
[IGA MH CR NT 13901-4]
[NIH/NIA 5R03AG042334-02]
Grant number NIH: RO1CA113507
NIH: R01CA189224
National Science Centre Poland: N403 194340
National Science Centre Poland: N N401 612440
Milestone: 267398
Queensland Government Smart State Fellowship and Griffith Health Institute: RD12/0036/0030 FIS-ISCIII
Queensland Government Smart State Fellowship and Griffith Health Institute: S2011/BMD-2328 TIRONET
Queensland Government Smart State Fellowship and Griffith Health Institute: SAF2013-44709-R
Fondazione Cassa di Risparmio di Perugia and Associazione Italiana per la Ricerca sul Cancro: IG 9338
IGA MH CR NT: 13901-4
Italian Government-Ministero della Salute:RF-2011-02350857
NIH/NIA: 5R03AG042334-02
Korean Foundation for Cancer Research: CB-2011-03-02
FAPESP: 2012/02902-9
FAPESP: 2013/03867-5
AIRC: IG 10316
Shanghai Hospital Development Center: SHDC 12014229
Date 2016
Published in Journal Of Clinical Endocrinology & Metabolism. Cary, v. 101, n. 1, p. 263-273, 2016.
ISSN 0021-972X (Sherpa/Romeo, impact factor)
Publisher Oxford univ press inc
Extent 263-273
Origin https://doi.org/10.1210/jc.2015-2917
Access rights Closed access
Type Article
Web of Science ID WOS:000377212700034
URI http://repositorio.unifesp.br/handle/11600/49497

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