Department of Surgery, Kuma Hospital, Kobe 650-0011, Japan.
Endocr J. 2013;60(6):829-33. doi: 10.1507/endocrj.ej12-0454. Epub 2013 Jan 29.
In contrast to minimally invasive follicular thyroid carcinoma (FTC), widely invasive FTC is aggressive and is associated with a dire prognosis. However, prognostic factors of widely invasive FTC have not been intensively investigated. In this study, we investigated this issue in a series of 79 widely invasive FTC patients. In the subset of 70 patients who did not show distant metastasis at diagnosis (M0), only a tumor size larger than 4 cm had a prognostic impact on disease-free survival (DFS) both on uni- and multivariate analyses. Regarding the cause-specific survival (CSS) of 79 patients, only distant metastasis at diagnosis (M1) had a significant prognostic value on uni- and multivariate analyses. None of the 70 M0 patients with a tumor measuring 4 cm or less died of FTC. Other clinicopathological features such as age, gender, and oxyphilic carcinoma were of no prognostic value. These findings suggest that 1) M1 is the strongest prognostic factor for CSS of widely invasive FTC patients, and 2) a tumor size larger than 4 cm significantly affects the DFS and CSS of M0 patients. Aggressive therapies with careful follow-up are recommended, especially for these patients.
与微创滤泡状甲状腺癌 (FTC) 相反，广泛浸润性 FTC 侵袭性强，预后不良。然而，广泛浸润性 FTC 的预后因素尚未得到深入研究。在这项研究中，我们对 79 例广泛浸润性 FTC 患者进行了研究。在诊断时未发现远处转移 (M0) 的 70 例患者亚组中，只有肿瘤大小大于 4cm 才对无病生存率 (DFS) 具有预后影响，无论是单因素还是多因素分析。对于 79 例患者的特异性生存 (CSS)，只有诊断时的远处转移 (M1) 才具有显著的预后价值，无论是单因素还是多因素分析。在肿瘤大小为 4cm 或以下的 70 例 M0 患者中，无一例死于 FTC。其他临床病理特征，如年龄、性别和嗜酸细胞癌，均无预后价值。这些发现表明：1) M1 是广泛浸润性 FTC 患者 CSS 的最强预后因素；2) 肿瘤大小大于 4cm 显著影响 M0 患者的 DFS 和 CSS。建议对这些患者进行积极的治疗并进行密切随访。
