Minimally invasive follicular thyroid carcinomas: prognostic factors

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• 作者：Gustav Stenson ; Inga-Lena Nilsson ; Ninni Mu ; Catharina Larsson…
• 刊名：Endocrine
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：53
• 期：2
• 页码：505-511
• 全文大小：520 KB
• 刊物主题：Endocrinology; Diabetes; Internal Medicine; Science, general;
• 出版者：Springer US
• ISSN：1559-0100
• 卷排序：53

文摘

Although minimally invasive follicular thyroid carcinoma (MI-FTC) is regarded as an indolent tumour, treatment strategies remain controversial. Our aim was to investigate the outcome for patients with MI-FTC and to identify prognostic parameters to facilitate adequate treatment and follow-up. This retrospective follow-up study involved all cases of MI-FTC operated at the Karolinska University Hospital between 1986 and 2009. Outcome was analysed using death from MI-FTC as endpoint. Fifty-eight patients (41 women and 17 men) with MI-FTC were identified. The median follow-up time was 140 (range 21–308) months. Vascular invasion was observed in 36 cases and was associated with larger tumour size [median 40 (20–76) compared with 24 (10–80) mm for patients with capsular invasion only (P = 0.001)] and older patients [54 (20–92) vs. 44 (11–77) years; P = 0.019]. Patients with vascular invasion were more often treated with thyroidectomy (21/36 compared to 7/22 with capsular invasion only; P = 0.045). Five patients died from metastatic disease of FTC after a median follow-up of 114 (range 41–193) months; all were older than 50 years (51–72) at the time of the initial surgery; vascular invasion was present in all tumours and all but one were treated with thyroidectomy. Univariate analysis identified combined capsular and vascular invasion (P = 0.034), age at surgery ≥50 years (P = 0.023) and male gender (P = 0.005) as related to risk of death from MI-FTC. MI-FTC should not be considered a purely indolent disease. Age at diagnosis and the existence of combined capsular and vascular invasion were identified as important prognostic factors.KeywordsFollicularThyroidCarcinomaMinimally invasivePrognosis