Diagnostic and therapeutic strategies for minimally and widely invasive follicular thyroid carcinomas

被引:39
作者
Huang, Chao-Chun [1 ]
Hsueh, Chuen [2 ]
Liu, Feng-Hsuan [1 ]
Chao, Tzu-Chieh [3 ]
Lin, Jen-Der [1 ]
机构
[1] Chang Gung Univ, Chang Gung Mem Hosp, Dept Internal Med, Div Endocrinol & Metab, Taoyuan Hsien, Kweishan County, Taiwan
[2] Chang Gung Univ, Chang Gung Mem Hosp, Dept Pathol, Taoyuan Hsien, Kweishan County, Taiwan
[3] Chang Gung Univ, Chang Gung Mem Hosp, Dept Gen Surg, Taoyuan Hsien, Kweishan County, Taiwan
来源
SURGICAL ONCOLOGY-OXFORD | 2011年 / 20卷 / 01期
关键词
Follicular neoplasm; Thyroid nodule; Near-total thyroidectomy; Thyroglobulin; COMPLETION THYROIDECTOMY; HURTHLE CELL; CANCER; RADIOIODINE; METASTASES; MALIGNANCY; HISTOLOGY; SURVIVAL; ABLATION; NODULES;
D O I
10.1016/j.suronc.2009.06.006
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The purpose of this study is to investigate diagnostic and therapeutic strategies that will enable easy differentiation between minimally invasive follicular carcinoma (MIFC) and widely invasive follicular carcinoma (WIFC). We retrospectively reviewed 234 follicular thyroid carcinoma cases to compare the diagnostic and therapeutic characteristics between the minimally and the widely invasive types. Eighty-nine patients were diagnosed with MIFC (mean age, 39.2 +/- 14.9 years) and 145 were diagnosed with WIFC (mean age, 49.0 +/- 17.7 years). Low diagnostic accuracy from preoperative cytology and frozen sections resulted in 60 patients undergoing subtotal thyroidectomies and 57 cases required a second operation for complete thyroidectomy. Patients in the MIFC group were younger, and had small-sized tumors, lower postoperative thyroglobulin levels, lower recurrent rates and lower cancer mortality rates than those in the WIFC group. Diagnostic accuracy from frozen sections in the WIFC group was relatively better. After a mean follow-up period of 9.0 +/- 0.4 years, 41 of the 234 (17.5%) patients with follicular thyroid carcinoma had died due to thyroid cancer. All MIFC patients remained disease-free or had a recurrence-free status. In conclusion, both WIFC and MIFC are difficult to diagnose on the basis of preoperative examinations and frozen sections. Patients diagnosed with MIFC had responded positively to the treatment; however, for patients diagnosed with WIFC to become disease-free, early diagnosis and aggressive surgical therapies in combination with I-131 therapy were required. (C) 2009 Elsevier Ltd. All rights reserved.
引用
收藏
页码:1 / 6
页数:6
相关论文
共 24 条
[1]   Changing patterns in the incidence and survival of thyroid cancer with follicular phenotype - Papillary, follicular, and anaplastic: A morphological and epidemiological study [J].
Albores-Saavedra, Jorge ;
Henson, Donald Earl ;
Glazer, Evan ;
Schwartz, Arnold M. .
ENDOCRINE PATHOLOGY, 2007, 18 (01) :1-7
[2]  
[Anonymous], 2002, TNM CLASSIFICATION M
[3]   Radioiodine lobar ablation as an alternative to completion thyroidectomy in patients with differentiated thyroid cancer [J].
Bal, CS ;
Kumar, A ;
Pant, GS .
NUCLEAR MEDICINE COMMUNICATIONS, 2003, 24 (02) :203-208
[4]   Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: A Synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference [J].
Baloch, Zubair W. ;
LiVolsi, Virginia A. ;
Asa, Syl L. ;
Rosai, Juan ;
Merino, Maria J. ;
Randolph, Gregory ;
Vielh, Philippe ;
DeMay, Richard M. ;
Sidawy, Mary K. ;
Frable, William J. .
DIAGNOSTIC CYTOPATHOLOGY, 2008, 36 (06) :425-437
[5]   Follicular thyroid carcinoma - Prognostic factors and the role of radioiodine [J].
Chow, SM ;
Law, SCK ;
Mendenhall, WM ;
Au, SK ;
Yau, S ;
Yuen, KT ;
Law, CC ;
Lau, WH .
CANCER, 2002, 95 (03) :488-498
[6]   Follicular thyroid carcinoma: Histology and prognosis [J].
D'Avanzo, A ;
Treseler, P ;
Ituarte, PHG ;
Wong, MW ;
Streja, L ;
Greenspan, FS ;
Siperstein, AE ;
Duh, QY ;
Clark, OH .
CANCER, 2004, 100 (06) :1123-1129
[7]   Increasing incidence of thyroid cancer in the United States, 1973-2002 [J].
Davies, L ;
Welch, HG .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2006, 295 (18) :2164-2167
[8]  
DeLellis R.A. L. R., 2004, PATHOLOGY GENETICS T
[9]   Interobserver and intraobserver reproducibility in the histopathology of follicular thyroid carcinoma [J].
Franc, B ;
De la Salmonière, P ;
Lange, F ;
Hoang, C ;
Louvel, A ;
De Roquancourt, A ;
Vildé, F ;
Hejblum, G ;
Chevret, S ;
Chastang, C .
HUMAN PATHOLOGY, 2003, 34 (11) :1092-1100
[10]   Metastatic minimally invasive (encapsulated) follicular and Hurthle cell thyroid carcinoma: A study of 34 patients [J].
Goldstein, NS ;
Czako, P ;
Neill, JS .
MODERN PATHOLOGY, 2000, 13 (02) :123-130