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New Insights on the Importance of the Extent of Vascular Invasion in Widely Invasive Follicular Thyroid Carcinoma

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Abstract

Background

This study aimed to investigate the association between the extent of vascular invasion (VI) and the outcome of widely invasive follicular thyroid carcinoma (WI-FTC).

Methods

The records of 107 patients with WI-FTC confirmed by surgical specimens from January 2005 to December 2016 were retrospectively reviewed.

Results

Among the 107 patients with WI-FTC, those with a VI of < 4 (n = 62) and ≥ 4 (n = 45) had a 10 year cause-specific survival (CSS) rate of 97.7% and 89.4% (p = 0.008), respectively. Univariate analysis identified M1 (p = 0.001), and the number of VI of ≥ 4 as significant negative prognostic factors for CSS. Multivariate analysis identified M1 (hazard ratio [HR] = 9.366) as independent negative prognostic factor for CSS. Among the 72 patients with M0 WI-FTC, those with a VI of < 2 (n = 33) and ≥ 2 (n = 39) had a 10-year distant metastasis-free survival (DMFS) rate of 96.8% and 56.8% (p = 0.001), respectively. Univariate analysis identified age ≥ 55 years (p = 0.011), presence of VI, the number of VI of ≥ 2, and resection margin status (p < 0.001) as significant negative prognostic factors for DMFS. Multivariate analysis identified the number of VI ≥ 2 (HR = 9.137), and resection margin status (HR = 5.853) as independent negative prognostic factors for DMFS.

Conclusions

It may be unnecessary that WI-FTC with curative resection margin status and a VI of < 2, especially in capsular invasion only, routinely undergo completion thyroidectomy and postoperative ablation.

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Acknowledgements

We thank Enago (https://www.enago.jp/) for editing this manuscript.

Funding

No funding was received for this article.

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Authors and Affiliations

  1. Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama City, Kanagawa, 232-0024, Japan

    Haruhiko Yamazaki

  2. Department of Surgery, Ito Hospital, 4-3-6, Jingumae, Shibuya-Ku, Tokyo, 150-8308, Japan

    Haruhiko Yamazaki, Kiminori Sugino, Kenichi Matsuzu, Wataru Kitagawa, Mitsuji Nagahama & Koichi Ito

  3. Department of Pathology, Ito Hospital, 4-3-6, Jingumae, Shibuya-Ku, Tokyo, 150-8308, Japan

    Ryohei Katoh

  4. Department of Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama City, Kanagawa, 236-0004, Japan

    Yasushi Rino

Authors
  1. Haruhiko Yamazaki
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  2. Kiminori Sugino
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  3. Ryohei Katoh
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  4. Kenichi Matsuzu
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  5. Wataru Kitagawa
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  8. Koichi Ito
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Corresponding author

Correspondence to Haruhiko Yamazaki.

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Conflict of interest

The authors have nothing to disclose.

Ethical approval

The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The protocol used in the present retrospective study was approved by the Ethics Committee of Ito Hospital (Approval No. 389).

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Informed consent was waived because of the retrospective nature of the study.

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Yamazaki, H., Sugino, K., Katoh, R. et al. New Insights on the Importance of the Extent of Vascular Invasion in Widely Invasive Follicular Thyroid Carcinoma. World J Surg 47, 2767–2775 (2023). https://doi.org/10.1007/s00268-023-07127-w

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  • DOI: https://doi.org/10.1007/s00268-023-07127-w

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