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World Journal of Surgery

, Volume 30, Issue 5, pp 752–758 | Cite as

Classical and Follicular Variant of Papillary Thyroid Carcinoma: A Comparative Study on Clinicopathologic Features and Long-term Outcome

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

Abstract

Introduction

The follicular variant of papillary thyroid carcinoma (FVPTC) is the most common histologic subtype of papillary thyroid carcinoma (PTC). However, it is still controversial whether FVPTC should behave differently from classical PTC (CPTC). The present study aimed at evaluating any potential difference in clinicopathologic features and long-term outcome of FVPTC as compared with CPTC.

Patients and Methods

Of 568 patients with PTC managed from 1973 to 2004, 308 were shown to have CPTC (54.2%) and 67 (11.8%) FVPTC after histologic review. The mean (± SD) follow-up period was 11.3 (± 8.9) years. The two groups were compared in terms of clinicopathological features, treatment received, and outcome regarding recurrence and disease-specific survival.

Results

There was no difference in age and gender ratio between the CPTC and FVPTC patients. Both groups had similar tumor characteristics in terms of tumor size, presence of multifocality, capsular invasion, lymphovascular permeation, and perineural infiltration. However, FVPTC patients had significantly fewer histologically confirmed cervical lymph node metastases (P = 0.027) and extrathyroidal involvement (P = 0.005). The proportion of bilateral resection, adjuvant radioactive iodine, and lymph node dissection did not differ significantly between the two groups. The FVPTC patients had a more favorable tumor risk by DeGroot classification (P = 0.003) and MACIS (Metastasis, Age, Completeness of excision, Invasiveness, and Size) score (P = 0.026). The 10- and 15-year actuarial disease-specific survivals did not differ significantly between FVPTC and CPTC patients (96.2% versus 90.7% and 96.2% versus 89.1%, respectively).

Conclusions

Although patients with FVPTC had more favorable clinicopathologic features and a better tumor risk group profile, their long-term outcome was similar to that of CPTC patients.

Keywords

Papillary Thyroid Carcinoma Papillary Carcinoma Radioactive Iodine Extrathyroidal Extension Follicular Variant 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirurgie 2006

Authors and Affiliations

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

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