Endocrinol Metab.  2021 Jun;36(3):619-627. 10.3803/EnM.2021.974.

Clinicopathological Characteristics and Recurrence-Free Survival of Rare Variants of Papillary Thyroid Carcinomas in Korea: A Retrospective Study

Affiliations
  • 1Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
  • 2Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
  • 3Division of Endocrinology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
  • 4Department of Pathology, Chung-Ang University College of Medicine, Seoul, Korea
  • 5Department of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea
  • 6Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
  • 7Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
  • 8Department of Radiology, School of Medicine, Kangwon National University Hospital, Chuncheon, Korea
  • 9Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
  • 10Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
  • 11Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Background
We aimed to evaluate the clinicopathological features and biological behaviors of Korean thyroid cancer patients with rare variants of papillary thyroid carcinoma (PTC) to address the ambiguity regarding the prognostic consequences of these variants.
Methods
We retrospectively reviewed the medical records of 5,496 patients who underwent thyroid surgery for PTC, between January and December 2012, in nine tertiary hospitals. Rare PTC variants included tall cell (TCV), columnar cell (CCV), diffuse sclerosing (DSV), cribriform-morular (CMV), solid (SV), hobnail, and Warthin-like variants. Recurrence-free survival (RFS) was defined as the time from the date of thyroidectomy until recurrence.
Results
Rare variants accounted for 1.1% (n=63) of the PTC patients; with 0.9% TCV, 0.02% CCV, 0.1% DSV, 0.1% CMV, and 0.1% SV. The mean age of patients and primary tumor size were 42.1±13.1 years and 1.3±0.9 cm, respectively. Extrathyroidal extension and cervical lymph node metastasis were observed in 38 (60.3%) and 37 (58.7%) patients, respectively. Ultrasonographic findings revealed typical malignant features in most cases. During a median follow-up of 7 years, 6.3% of patients experienced a locoregional recurrence. The 5-year RFS rates were 71.4% in patients with DSV or SV, 95.9% for TCV, or CCV, and 100% for other variants. DSV emerged an independent risk factor associated with shorter RFS.
Conclusion
In this multicenter Korean cohort, rare variants accounted for 1.1% of all PTC cases, with TCV being the most frequent subtype. DSV emerged as a significant prognostic factor for RFS.

Keyword

Thyroid neoplasms; Carcinoma; papillary; Prognosis; Recurrence; Prevalence
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