Korean J Intern Med.  2014 May;29(3):325-333. 10.3904/kjim.2014.29.3.325.

Follicular and Hurthle cell carcinoma of the thyroid in iodine-sufficient area: retrospective analysis of Korean multicenter data

• Kim WG
• Kim TY
• Kim TH
• Jang HW
• Jo YS
• Park YJ
• Kim SW
• Kim WB
• Shong M
• Park DJ
• Chung JH
• Shong YK
• Cho BY

• KMID: 1792058
• DOI: http://doi.org/10.3904/kjim.2014.29.3.325

Abstract

BACKGROUND/AIMS
Follicular thyroid carcinoma (FTC) and Hurthle cell carcinoma (HCC) of the thyroid are relatively uncommon thyroid malignancies in iodine-sufficient areas. In this study we evaluated the clinical behavior, prognostic factors and treatment outcomes of FTC and HCC in Korea.
METHODS
This multicenter study included 483 patients with FTC and 80 patients with HCC who underwent an initial surgery between 1995 and 2006 in one of the four tertiary referral hospitals in Korea. We evaluated clinicopathological factors associated with distant metastases and recurrence during a median of 6 years of follow-up.
RESULTS
HCC patients were significantly older (49 years vs. 43 years; p < 0.001) and had more lymphovascular invasions (22% vs. 14%; p = 0.03) compared with FTC patients. Distant metastases were confirmed in 40 patients (8%) in the FTC group and in two patients (3%) in the HCC group (p = 0.07). Distant metastases were significantly associated with older age, widely invasive cancer and extrathyroidal invasion. Only 14 patients (3%) had recurrent disease and there was no significant difference between FTC and HCC groups (p = 0.38). Recurrence was associated with larger tumor size and cervical lymph node metastasis.
CONCLUSIONS
HCC patients were older and had more lymphovascular invasions than FTC patients. However, FTC and HCC patients had similar initial clinicopathological features. Older age, wide invasiveness and extrathyroidal invasion were independent risk factors for predicting distant metastases in FTC and HCC patients.

Keyword

Follicular adenocarcinoma; Hurthle cell thyroid cancer; Distant metastases; Prognosis; Iodine

MeSH Terms

Adenocarcinoma, Follicular/*epidemiology/secondary/surgery
Adult
Age Factors
*Diet
Female
Humans
*Iodine
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Recurrence, Local
*Nutritional Status
Republic of Korea/epidemiology
Retrospective Studies
Risk Factors
Tertiary Care Centers
Thyroid Neoplasms/*epidemiology/pathology/surgery
Thyroidectomy
Time Factors
Treatment Outcome
Iodine