J Korean Surg Soc.  2010 Mar;78(3):149-156. 10.4174/jkss.2010.78.3.149.

Prognostic Factors and Treatment in Follicular Thyroid Carcinoma

• Kim WW
• Hur SM
• Kim SH
• Lee SK
• Kim S
• Oh YL
• Choe JH
• Lee JE
• Kim JH
• Nam SJ
• Yang JH
• Kim JS

• KMID: 2211942
• DOI: http://doi.org/10.4174/jkss.2010.78.3.149

Abstract

PURPOSE
Follicular thyroid carcinoma (FTC) and papillary thyroid carcinoma (PTC) are two main subtypes of well-differentiated thyroid cancer. Sometimes FTCs present more aggressive features such as vascular invasion. The object of this study was to investigate the clinicopathologic features, prognostic factors and treatment outcome of FTC.
METHODS
This retrospective study enrolled 91 patients diagnosed with FTC between November 1994 and October 2008. The clinicopathologic characteristics, treatment outcome and follow up data were analyzed.
RESULTS
The median follow-up (f/u) period was 76.1 months. Distant metastases at the time of diagnosis were detected in 12 patients. During the f/u period, one local recurrence and 4 distant metastases developed. Local recurrence or distant metastasis were noticed in 12 out of 19 patients with widely invasive type and 5 out of 36 patients with minimally invasive type with vascular invasion were also noted. The median times to local recurrence or distant metastasis were 59.0 and 34.2 months, respectively. On analysis, according to the clinocopathologic factors, presence of vascular invasion, extrathyroidal extension, invasion to structure, incomplete excision and pathological classification were independent prognostic factors for recurrence or distant metastasis. Disease specific mortality was seen in one patient.
CONCLUSION
This study shows that aggressive treatments such as total thyroidectomy followed by radioiodine therapy and close follow-up of patients with minimally invasive type with vascular invasion and widely invasive type of FTC should be considered due to the chance of local recurrence and distant metastasis.

Keyword

Follicular thyroid carcinoma; Prognostic factor; Treatment

MeSH Terms

Adenocarcinoma, Follicular
Carcinoma
Follow-Up Studies
Humans
Neoplasm Metastasis
Recurrence
Retrospective Studies
Thyroid Neoplasms
Thyroidectomy
Treatment Outcome
Carcinoma
Thyroid Neoplasms

Figure

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  Fig. 1 Disease free survival curve for patients with FTC (follicular thyroid carcinoma) according to pathological classification. Event = local recurrence or distant metastasis, Group 1 = minimally invasive FTC without vascular invasion, Group 2 = minimally invasive FTC with vascular invasion, Group 3 = widely invasive FTC, P<0.001.

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