Long-term outcomes of follicular variant vs classic papillary thyroid carcinoma
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-...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2018-11-01
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| Series: | Endocrine Connections |
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| Online Access: | https://ec.bioscientifica.com/view/journals/ec/7/12/EC-18-0264.xml |
| _version_ | 1798045093523881984 |
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| author | Lauren E Henke John D Pfeifer Thomas J Baranski Todd DeWees Perry W Grigsby |
| author_facet | Lauren E Henke John D Pfeifer Thomas J Baranski Todd DeWees Perry W Grigsby |
| author_sort | Lauren E Henke |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-11T23:14:59Z |
| format | Article |
| id | doaj.art-2272820b235b40dbafc26b47e85c641c |
| institution | Directory Open Access Journal |
| issn | 2049-3614 2049-3614 |
| language | English |
| last_indexed | 2024-04-11T23:14:59Z |
| publishDate | 2018-11-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrine Connections |
| spelling | doaj.art-2272820b235b40dbafc26b47e85c641c2022-12-22T03:57:38ZengBioscientificaEndocrine Connections2049-36142049-36142018-11-0171212261235https://doi.org/10.1530/EC-18-0264Long-term outcomes of follicular variant vs classic papillary thyroid carcinomaLauren E Henke0John D Pfeifer1Thomas J Baranski2Todd DeWees3Perry W Grigsby4Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri, USADepartment of Pathology, Washington University School of Medicine, St. Louis, Missouri, USADivision of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, Washington University School of Medicine, Saint Louis, Missouri, USADivision of Biomedical Statistics and Informatics, Mayo Clinic, Scottsdale, Arizona, USADepartment of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri, USA; Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, Missouri, USAThe 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.https://ec.bioscientifica.com/view/journals/ec/7/12/EC-18-0264.xmlclassic papillary thyroid carcinomafollicular variant of papillary thyroid carcinomaBRAF mutationC-PTCFV-PTC |
| spellingShingle | Lauren E Henke John D Pfeifer Thomas J Baranski Todd DeWees Perry W Grigsby Long-term outcomes of follicular variant vs classic papillary thyroid carcinoma Endocrine Connections classic papillary thyroid carcinoma follicular variant of papillary thyroid carcinoma BRAF mutation C-PTC FV-PTC |
| title | Long-term outcomes of follicular variant vs classic papillary thyroid carcinoma |
| title_full | Long-term outcomes of follicular variant vs classic papillary thyroid carcinoma |
| title_fullStr | Long-term outcomes of follicular variant vs classic papillary thyroid carcinoma |
| title_full_unstemmed | Long-term outcomes of follicular variant vs classic papillary thyroid carcinoma |
| title_short | Long-term outcomes of follicular variant vs classic papillary thyroid carcinoma |
| title_sort | long term outcomes of follicular variant vs classic papillary thyroid carcinoma |
| topic | classic papillary thyroid carcinoma follicular variant of papillary thyroid carcinoma BRAF mutation C-PTC FV-PTC |
| url | https://ec.bioscientifica.com/view/journals/ec/7/12/EC-18-0264.xml |
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