The majority of papillary thyroid carcinoma (PTC) cases comprise classic papillary (C-PTC) and follicular variant (FV-PTC) histologic sub-types. Historically, clinical equivalency was assumed, but recent data suggest C-PTC may have poorer outcomes. However, large single-institution series with long-term outcomes of C-PTC and FV-PTC, using modern pathologic criteria for FV-PTC, are needed. Our objective was to compare prevalence and impact of clinicopathologic factors, including BRAF mutation status, on long-term outcomes of C-PTC and FV-PTC. We hypothesized that patients with C-PTC would have higher risk disease features and worse survival outcomes. This retrospective study included 1293 patients treated at a single, US academic institution between 1943 and 2009 with mean follow-up of 8.6 years. All patients underwent either partial or total thyroidectomy and had invasive C-PTC or FV-PTC per modern pathology criteria. Primary study measurements included differences in recurrence-free survival (RFS), disease-specific survival (DSS) and associations with clinicopathologic factors including the BRAF mutation. Compared to FV-PTC, C-PTC was associated with multiple features of high-risk disease (P < 0.05) and significantly reduced RFS and DSS. Survival differences were consistent across univariate, multivariate and Kaplan–Meier analyses. BRAF mutations were more common in C-PTC (P = 0.002). However, on Kaplan–Meier analysis, mutational status did not significantly impact RFS or DSS for patients with either histologic sub-type. C-PTC therefore indicates higher-risk disease and predicts for significantly poorer long-term outcomes when compared to FV-PTC. The nature of this difference in outcome is not explained by traditional histopathologic findings or by the BRAF mutation.
Lauren E Henke, John D Pfeifer, Thomas J Baranski, Todd DeWees and Perry W Grigsby
Huy Gia Vuong, Nguyen Phuoc Long, Nguyen Hoang Anh, Tran Diem Nghi, Mai Van Hieu, Le Phi Hung, Tadao Nakazawa, Ryohei Katoh and Tetsuo Kondo
. ( https://doi.org/10.1016/j.surg.2013.05.009 ) 10.1016/j.surg.2013.05.009 24238051 6 Oh WJ Lee YS Cho U Bae JS Lee S Kim MH Lim DJ Park GS Lee YS Jung CK . Classic papillary thyroid carcinoma with tall cell features and tall cell variant have similar
Dario de Biase, Federica Torricelli, Moira Ragazzi, Benedetta Donati, Elisabetta Kuhn, Michela Visani, Giorgia Acquaviva, Annalisa Pession, Giovanni Tallini, Simonetta Piana and Alessia Ciarrocchi
ctrl-PTCs 66 19 M47 F 49 C-PTC8 TCV-PTC8 FV-PTC1 ST-PTC 142.1 ms (77–373) 5 AWD55 NED4 DOC2 NA ATC, anaplastic thyroid carcinoma; AWD, alive with disease; C-PTC, classic papillary thyroid carcinoma; ctrl-PTCs, control group (N0