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
.1016/j.surg.2013.05.009 ) 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 clinicopathologic features . Korean Journal of Pathology
Ana P Estrada-Flórez, Mabel E Bohórquez, Alejandro Vélez, Carlos S Duque, Jorge H Donado, Gilbert Mateus, Cesar Panqueba-Tarazona, Guadalupe Polanco-Echeverry, Ruta Sahasrabudhe, Magdalena Echeverry and Luis G Carvajal-Carmona
variant vs classic papillary thyroid carcinoma . Endocrine Connections 2018 1226 – 1235 . ( https://doi.org/10.1530/EC-18-0264 ) 45 Nixon IJ Wang LY Palmer FL Tuttle RM Shaha AR Shah JP Patel SG Ganly I . The impact of nodal status
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