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Survival with Follicular and Hurthle Cell Microcarcinoma Compared to Papillary Thyroid Microcarcinoma: A Population Study of 84,532 Patients

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Abstract

Background

This study compares survival in patients with the rare subtypes of follicular (FTmC) and Hurthle cell (HCmC) microcarcinoma compared to that of papillary thyroid (PTmC) microcarcinoma.

Methods

Patients with FTmC and HCmC were selected from the National Cancer Database 2004–2015 and compared with PTmC. Patient clinicopathological characteristics and overall survival (OS) were analyzed. Multivariable logistic and Cox regression analysis evaluated binary outcomes and predictors of survival. A propensity score matched analysis using age, gender, race, extrathyroidal extension (ETE), nodal status, distant metastasis, radiation, and operation was performed to evaluate the difference in OS with FTmC, HCmC, and PTmC.

Results

We identified 858 FTmC, 476 HCmC, and 82,056 PTmC. FTmC was less likely to have macroscopic ETE compared to PTmC (2.6% vs. 3.1% p = 0.03), but more likely to have distant metastasis (2.3% vs. 0.2%, p < 0.01). FTmC and HCmC were less likely to have nodal metastasis (2.7%, 2.5% vs. 10.9%, p < 0.01). Ten-year OS was decreased in patients with FTmC (91.4%, p = 0.04) and HCmC (89.8%, p < 0.01) compared to PTmC (93.5%). On multivariable analysis, histology was not associated with OS. With HCmC, older age (OR 1.13, p < 0.01) and male gender (OR 2.72, p = 0.03) were associated with decreased OS. In propensity matched analysis, there was no difference in 10-year OS with FTmC and PTmC (91.4% vs. 93.7%, p = 0.54), but HCmC had decreased OS compared to PTmC (89.8% vs. 94.3%, p = 0.04).

Conclusions

Patients with FTmC have comparable OS to those with PTmC, but HCmC has decreased OS especially in older and male patients.

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References

  1. Aschebrook-Kilfoy B, Grogan R, Ward M et al (2013) Follicular thyroid cancer incidence patterns in the United States, 1980–2009. Thyroid 23:1015–1021

    Article  Google Scholar 

  2. LiVolsi V, Asa S (1994) The demise of follicular carcinoma of the thyroid gland. Thyroid 4:233–236

    Article  CAS  Google Scholar 

  3. Hundahl S, Fleming I, Fremgen A, Menck H (1998) A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985–1995. Cancer 83:2638–2648

    Article  CAS  Google Scholar 

  4. Ganly I, Ricarte Filho J, Eng S et al (2013) Genomic dissection of Hurthle cell carcinoma reveals a unique class of thyroid malignancy. J Clin Endocrinol Metab 98:E962–972

    Article  Google Scholar 

  5. Ito Y, Miyauchi A, Inoue H et al (2010) An observational trial for papillary thyroid microcarcinoma in Japanese patients. World J Surg 34:28–35. https://doi.org/10.1007/s00268-009-0303-0

    Article  PubMed  Google Scholar 

  6. Ito Y, Miyauchi A, Kihara M et al (2014) Patient age is significantly related to the progression of papillary microcarcinoma of the thyroid under observation. Thyroid 24:27–34

    Article  CAS  Google Scholar 

  7. Sugitani I, Toda K, Yamada K et al (2010) Three distinctly different kinds of papillary thyroid microcarcinoma should be recognized: our treatment strategies and outcomes. World J Surg 34:1222–1231. https://doi.org/10.1007/s00268-009-0359-x

    Article  PubMed  Google Scholar 

  8. Charlson M, Pompei P, Ales K et al (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis 40:373–383

    Article  CAS  Google Scholar 

  9. Statistical Analysis System Version 9.3 SAS Institute, Cary, NC

  10. Haugen B, Alexander E, Bible K et al (2016) 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid 26:1–133

    Article  Google Scholar 

  11. Ganly I, McFadden D (2019) Short Review: genomic alterations in Hurthle cell carcinoma. Thyroid 4:471–479

    Article  Google Scholar 

  12. Ganly I, Ricarte F, Eng S et al (2013) Genomic dissection of Hurthle cell carcinoma reveals a unique class of thyroid malignancy. J Clin Endocrinol Metab 5:E962–E972

    Article  Google Scholar 

  13. Miyauchi A, Ito Y, Oda H (2018) Insights into the management of papillary thyroid microcarcinoma of the thyroid. Thyroid 28:22–31

    Article  Google Scholar 

  14. Kuo E, Roman S, Sosa J (2013) Patients with follicular and Hurthle cell microcarcinoma have compromised survival: a population level study of 22,738 patients. Surgery 154:1246–1254

    Article  Google Scholar 

  15. Mills S, Haq M, Smellie W et al (2009) Hürthle cell carcinoma of the thyroid: retrospective review of 62 patients treated at the Royal Marsden Hospital between 1946 and 2003. Eur J Surg Oncol 35:230–234

    Article  CAS  Google Scholar 

  16. Oluic B, Paunovic I, Loncar Z et al (2017) Survival and prognostic factors for survival, cancer specific survival and disease free interval in 239 patients with Hurthle cell carcinoma: a single center experience. BMC Cancer 17:371

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported by the NorthShore University Research Institute and the University of Chicago Graduate Medical Education.

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Authors and Affiliations

  1. Department of Surgery, NorthShore University HealthSystem, 2650 Ridge Ave, Walgreen Suite 2507, Evanston, IL, 60201, USA

    Amna M. Khokar, Simon A. Holoubek, David J. Winchester, Richard A. Prinz & Tricia A. Moo-Young

  2. Department of Surgery, University of Chicago, Chicago, IL, USA

    Amna M. Khokar, David J. Winchester, Richard A. Prinz & Tricia A. Moo-Young

  3. Bioinformatics and Research Core, NorthShore University HealthSystem, 2650 Ridge Ave, Walgreen Suite 2507, Evanston, IL, 60201, USA

    Kristine M. Kuchta

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  1. Amna M. Khokar
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  2. Simon A. Holoubek
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  4. David J. Winchester
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  6. Tricia A. Moo-Young
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Correspondence to Tricia A. Moo-Young.

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Khokar, A.M., Holoubek, S.A., Kuchta, K.M. et al. Survival with Follicular and Hurthle Cell Microcarcinoma Compared to Papillary Thyroid Microcarcinoma: A Population Study of 84,532 Patients. World J Surg 44, 469–478 (2020). https://doi.org/10.1007/s00268-019-05264-9

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