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Prognostic Indications for Hürthle Cell Cancer

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Abstract

Hürthle cell carcinoma (HCC) has been reported to have variable clinical behavior. The objective of this study was to determine the important prognostic factors in patients with HCC. It was a retrospective investigation of 33 patients with HCC treated in our institution from 1976 to 2002. The average age of our 33 patients with HCC was 55.2 years (range 20–82 years; 23 women, 10 men). Fifteen patients (45.5%) presented with a T2 tumor, 7 (21.2%) with a T3 tumor, and 8 (24.2%) with a T4 tumor; the tumor stage was unknown in three patients. Coexisting papillary carcinoma occurred in six patients (18%), 9% of whom presented with metastatic disease. Twelve patients (36.4%) had metastases, four of whom (12.2%) had persistent HCC, and 8 (24.2%) developed recurrent HCC (range 1–9 years). Eight of these twelve patients (66.7%) died from the HCC. The average follow-up time was 5.5 years (range 1–16 years). Altogether, 3 of 23 women and 5 of 10 men died from their HCC (p < 0.05). Of the 22 patients with T2-T3 tumors, 5 (22.7%) developed metastases and 1 patient died; 5 of 8 patients (62.5%) with T4 tumors developed metastases and died (p < 0.01). Patients who were treated by less than total thyroidectomy had a worse prognosis by univariate analysis (p < 0.01) but not by multivariate analysis. Survival time for patients with persistent disease was shorter than for those with recurrent disease (p < 0.05). Multivariate analysis, however, revealed no difference for extent of operation or those with persistent and recurrent disease. The cause-specific survivals were 74% and 49% at 5 and 10 years, respectively. Disease-free survivals were 65.0% and 40.5% at 5 and 10 years, respectively. Our findings show that gender and stage of disease influence the prognosis of patients with HCC.

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Acknowledgments

This study was supported in part by the Friends of Endocrine Surgery, the Albert Clark Family Foundation, the Helen and Sanford Diller Foundation, the Jerold Heller Family Foundation, and Mt. Zion Health Systems.

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Authors and Affiliations

  1. Endocrine Surgical Oncology, Department of Surgery, University of California, San Francisco/Mount Zion Medical Center, 1600 Divisadero Street, 94143-1674, San Francisco, California, USA

    Yevgeniya Kushchayeva M.D.

  2. Surgical Service, Veterans Affairs Medical Center, 4150 Clement Street, 94121, San Francisco, California, USA

    Quan-Yang Duh M.D.

  3. Department of Surgery, School of Medicine, University of California San Francisco, 501 Parnassus Avenue, 91443, San Francisco, California, USA

    Electron Kebebew M.D.

  4. Department of Surgery, University of California San Francisco/Mount Zion Medical Center, 94143-1674, 1600 Divisadero StreetSan Francisco, California, USA

    Orlo H. Clark M.D.

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  1. Yevgeniya Kushchayeva M.D.
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  3. Electron Kebebew M.D.
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Correspondence to Orlo H. Clark M.D..

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Kushchayeva, Y., Duh, QY., Kebebew, E. et al. Prognostic Indications for Hürthle Cell Cancer. World J. Surg. 28, 1266–1270 (2004). https://doi.org/10.1007/s00268-004-7602-2

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