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Prevalence and Prognostic Significance of Poor Differentiation and Tall Cell Variant in Papillary Carcinoma in Japan

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Abstract

Background

In the 1980s, histology of a poorly differentiated carcinoma showing an aggressive behavior was proposed by Sakamoto et al. and other pathologists. This was adopted as an independent entity by the World Health Organization (WHO) and in the General Rules for the Description of Thyroid Cancer by The Japanese Society of Thyroid Surgery (JSTS). Furthermore, the Turin classification was recently proposed as the newest classification system for poorly differentiated carcinoma. Furthermore, although tall cell variant is not included in poorly differentiated carcinoma, it is thought to show aggressive characteristics. In this study, we investigated the prevalence and clinical significance of three types of poorly differentiated carcinoma defined by the WHO classification system (poorly differentiated carcinoma [WHO]), Turin proposal (poorly differentiated carcinoma [Turin]), and JSTS (poorly differentiated carcinoma [Sakamoto]), and tall cell variant in papillary carcinoma.

Methods

We investigated the prevalence and prognostic significance of these three histological types in 1707 papillary carcinomas.

Results

In our series, 189 (11.1%), 15 (0.8%), 5 (0.3%), and 62 (3.6%) patients were diagnosed as having poorly differentiated carcinoma (Sakamoto), poorly differentiated carcinoma (WHO), poorly differentiated carcinoma (Turin), and tall cell variant, respectively. Poorly differentiated carcinoma (WHO) and tall cell variant independently affected cause-specific survival (CSS) of patients, but poorly differentiated carcinoma (Sakamoto) predicted only worse disease-free survival (DFS) of patients on multivariate analysis. Poorly differentiated carcinoma (Turin) showed the worst DFS and CSS rates of patients but was not confirmed as an independent prognostic factor probably because of the small number of patients.

Conclusions

Poorly differentiated carcinoma (WHO) and tall cell variant significantly affected patient prognosis. Poorly differentiated carcinoma (Turin) accounts only for 0.3% but showed the worst survival rates. Although poorly differentiated carcinoma (Sakamoto) predicted the likelihood of carcinoma recurrence, it is more appropriate to define this lesion as one of the histological subtypes of papillary carcinoma rather than as an independent histological entity.

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References

  1. Sobin LH, Wittekind Ch (eds) (2002) UICC: TNM classification of malignant tumors, 6th ed. Wiley-Liss, New York

    Google Scholar 

  2. Ito Y, Miyauchi A, Jikuzono T, Higashiyama T, Takamura T, Miya A, Kobayashi K, Matsuzuka F, Ichihara K, Kuma K (2007) Risk factors contributing to a poor prognosis of papillary thyroid carcinoma; Validity of UICC/AJCC TNM classification and stage grouping. World J Surg 31:838–848

    Article  PubMed  Google Scholar 

  3. Ito Y, Hirokawa M, Jikuzono T, Higashiyama T, Takamura Y, Miya A, Kobayashi K, Matsuzuka F, Kuma K, Miyauchi A (2007) Extranodal tumor extension to adjacent organs predicts a worse cause-specific survival in patients with papillary thyroid carcinoma. World J Surg 31:1196–1203

    Article  Google Scholar 

  4. Sakamoto A, Kasai N, Sugano H (1983) Poorly differentiated carcinoma of the thyroid. A clinicopathologic entity for a high risk group of papillary and follicular carcinomas. Cancer 52:1849–1855

    Article  PubMed  CAS  Google Scholar 

  5. Carcangiu ML, Zampi G, Rosai J (1984) Poorly differentiated (“insular”) thyroid carcinoma. A reinterpretation of Langhans’ “Wuchernde Struma.” Am J Surg Pathol 8:655–668

    Article  PubMed  CAS  Google Scholar 

  6. Nishiyama RH (1999) Another dissertation on poorly differentiated carcinomas: is it really necessary? Adv Anat Pathol 6:281–286

    Article  PubMed  CAS  Google Scholar 

  7. Rosai J (2004) Poorly differentiated thyroid carcinoima: introduction to the issue, its landmarks, and clinical impact. Endocr Pathol 15:293–296

    Article  PubMed  Google Scholar 

  8. Sakamoto A (2004) Definition of poorly differentiated carcinoma of the thyroid: the Japanese experience. Endocr Pathol 15:307–311

    Article  PubMed  Google Scholar 

  9. Sobrinho-Simoes M (1996) Poorly differentiated thyroid carcinomas. Endocr Pathol 2:99–102

    Article  Google Scholar 

  10. Volante M, Landolfi S, Chiusa L, et al. (2004) Poorly differentiated carcinoma of the thyroid with trabecular, insular, and solid patterns: a clinicopathologic study of 183 patients. Cancer 100:950–957

    Article  PubMed  Google Scholar 

  11. Aklen LA, LiVolsi VA (2000) Poorly differentiated thyroid carcinoma – it is important. Am J Surg Pathol 24:310–313

    Article  Google Scholar 

  12. Nishida T, Katayama S, Tsujimoto M, Nakamura J, Matsuda H (1999) Clinicopathological significance of poorly differentiated thyroid carcinoma. Am J Surg Pathol 23:205–211

    Article  PubMed  CAS  Google Scholar 

  13. Wreesman V, Rhossein R (2002) Genome-wide appraisal of thyroid cancer progression. Am J Pathol 161:1549–1556

    Google Scholar 

  14. Hiltizik D, Carlson DL, Tuttle RM, et al. (2006) Poorly differentiated thyroid carcinomas defined on the basis of mitosis and necrosis. A clnicopathological study of 58 patients. Cancer 106:1286–1295

    Article  Google Scholar 

  15. Sobrinho-Simoes M, Carcangiu ML, Albores-Saavedra J, et al. (2004) Poorly differentiated carcinoma. In: DeLeillis RA, Lloyd RV, Heitz PU, et al. (eds) Pathology and genetics of tumous of endocrine organs. IARC Press, Lyon, pp 73–76

  16. Valante M, Collini P, Nikiforov EY, et al. (2007) Poorly differentiated thyroid carcinoma: the Turin proposal for the use of uniform diagnostic criteria and an algorhthmic diagnostic approach. Am J Surg Pathol 31:1256–1264

    Article  Google Scholar 

  17. The Japanese Society of Thyroid Surgery (2005) General rules for the description of thyroid cancer, 6th edn. Kanehara Press, Tokyo

    Google Scholar 

  18. Hawk WA, Hazard JB (1976) The many appearances of ppapillary carcinoma of the thyroid. Clevel Clin Q 43:207–215

    CAS  Google Scholar 

  19. Johnson TL, Lloyd RV, Thompson NW, Beierwaltes WH, Sisson JC (1988) Prognostic implications of the tall cell variant of papillary thyroid carcinoma. Am J Surg Pathol 12:22–27

    Article  PubMed  CAS  Google Scholar 

  20. Egea AM, Gonzales JMR, Perez JS, Cogollos TS, Paricio PP (1993) Prognostic value of the tall cell variety of papillary cancer of the thyroid. Eur J Surg Oncol 19:517–521

    Google Scholar 

  21. Michels JJ, Jacques M, Henry-Amar M, Bardet S (2007) Prevalence and prognostic significance of tall cell variant of papillary thyroid carcinoma. Human Pathol 38:212–219

    Article  Google Scholar 

  22. Sanders EM, LiVolsi VA, Brierley J, et al. (2007) An evidence-based review of poorly differentiated thyroid cancer. World J Surg 31:934–945

    Article  PubMed  Google Scholar 

  23. Akslen LA, LiVolsi VA (2000) Prognostic significance of histologic grading compared with subclassification of papillary thyroid carcinoma. Cancer 88:1902–1908

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Kuma Hospital, 8-2-35, Shimoyamate-dori, Chuo-ku, Kobe Cit, 650-0011, Japan

    Yasuhiro Ito, Mitsuyoshi Hirokawa, Mitsuhiro Fukushima, Hiroyuki Inoue, Tomonori Yabuta, Takashi Uruno, Minoru Kihara, Takuya Higashiyama, Yuuki Takamura, Akihiro Miya, Kaoru Kobayashi, Fumio Matsuzuka & Akira Miyauchi

  2. Department of Pathology, Kuma Hospital, 8-2-35, Shimoyamate-dori, Chuo-ku, Kobe Cit, 650-0011, Japan

    Mitsuyoshi Hirokawa

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  1. Yasuhiro Ito
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  2. Mitsuyoshi Hirokawa
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  3. Mitsuhiro Fukushima
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  4. Hiroyuki Inoue
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  5. Tomonori Yabuta
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  6. Takashi Uruno
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  7. Minoru Kihara
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  8. Takuya Higashiyama
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  9. Yuuki Takamura
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  10. Akihiro Miya
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  11. Kaoru Kobayashi
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  12. Fumio Matsuzuka
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  13. Akira Miyauchi
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Correspondence to Yasuhiro Ito.

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Ito, Y., Hirokawa, M., Fukushima, M. et al. Prevalence and Prognostic Significance of Poor Differentiation and Tall Cell Variant in Papillary Carcinoma in Japan. World J Surg 32, 1535–1543 (2008). https://doi.org/10.1007/s00268-007-9406-7

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  • DOI: https://doi.org/10.1007/s00268-007-9406-7

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