Annals of Surgical Oncology

, Volume 14, Issue 2, pp 730–738

Prognostic Factors in Papillary and Follicular Thyroid Carcinoma: Their Implications for Cancer Staging

  • Brian Hung-Hin Lang
  • Chung-Yau Lo
  • Wai-Fan Chan
  • King-Yin Lam
  • Koon-Yat Wan
Article

DOI: 10.1245/s10434-006-9207-5

Cite this article as:
Lang, B.HH., Lo, CY., Chan, WF. et al. Ann Surg Oncol (2007) 14: 730. doi:10.1245/s10434-006-9207-5

Abstract

Background

Papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) are two distinct histological types of thyroid carcinoma but have often been studied and staged as a collective group, known as differentiated thyroid carcinoma (DTC). However, this may not be an optimal approach to cancer staging.

Methods

A total of 760 patients with DTC, comprising 589 (77.5%) with PTC and 171 with (22.5%) FTC, being managed at our institution from 1961 to 2001 were retrospectively reviewed. Their clinicopathological features, treatment modalities received, and postoperative outcome were analyzed. Both univariate and multivariate analyses were performed to identify prognostic factors related to cancer-specific survival (CSS) for PTC and FTC.

Results

There were statistically significant differences between PTC and FTC in terms of age ≥50 years at diagnosis (P = .040), tumor size (P < .001), lymph node metastases (P < .001), distant metastases (P < .001), extrathyroidal extension (P < .001), multifocality (P = .002), capsular invasion (P < .001), extent of thyroid resection (P < .001), radioiodine ablation (P < .001), and external-beam irradiation (P = .003). Although PTC and FTC had similar 10-year and 15-year CSS (P = .846), each possessed its own set of independent prognostic factors for CSS. Age at diagnosis and completeness of resection were independent prognostic factors in both PTC and FTC.

Conclusions

There were marked differences in clinicopathologic features, treatment, and prognostic factors between the two histologic types of DTC. Different staging systems should be evaluated and validated for PTC and FTC individually in the future.

Keywords

Prognostic factorsDifferentiated thyroid carcinomaPapillary thyroid carcinomaFollicular thyroid carcinomaStagingRisk stratification

Copyright information

© Society of Surgical Oncology 2006

Authors and Affiliations

  • Brian Hung-Hin Lang
    • 1
  • Chung-Yau Lo
    • 1
  • Wai-Fan Chan
    • 1
  • King-Yin Lam
    • 2
  • Koon-Yat Wan
    • 3
  1. 1.Division of Endocrine Surgery, Department of SurgeryUniversity of Hong Kong Medical Centre, Queen Mary HospitalHong Kong SARChina
  2. 2.Discipline of Pathology, School of MedicineGriffith UniversityGold CoastAustralia
  3. 3.Department of Clinical OncologyUniversity of Hong Kong Medical Centre, Queen Mary HospitalHong Kong SARChina