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Published in: World Journal of Surgery 7/2015

01-07-2015 | Original Scientific Report

Clinicopathologic Features and Outcomes in Patients with Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma

Authors: Junko Akaishi, Kiminori Sugino, Kaori Kameyama, Chie Masaki, Kenichi Matsuzu, Akifumi Suzuki, Takashi Uruno, Keiko Ohkuwa, Hiroshi Shibuya, Wataru Kitagawa, Mitsuji Nagahama, Kazuo Shimizu, Koichi Ito

Published in: World Journal of Surgery | Issue 7/2015

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Abstract

Background

Diffuse sclerosing variant (DSV) of papillary thyroid carcinoma (PTC) is a rare variant more common among younger patients.

Materials and methods

Excluding patients with microcarcinoma, 5848 patients with PTC underwent initial surgery between 1995 and 2011. Twenty-two patients (0.4 %) were histologically diagnosed with DSV, of whom 20 (91 %) were <45 years old. We compared clinicopathologic characteristics and outcomes between patients with DSV and those with classical PTC <45 years old. Univariate analysis by the Kaplan–Meier method in relation to cause-specific survival (CSS) and disease-free survival (DFS) rates was performed with regard to the following variables: sex; anti-thyroglobulin antibody (TgAb) positivity; presence of distant metastasis; pathological lymph node metastasis; extra-thyroidal invasion; and pathological variant (classical vs. DSV).

Results

The 20 patients with DSV <45 years old comprised 18 females and 2 males. Frequencies of TgAb, pN1b, and local recurrence were higher in the DSV group than in the classical PTC group. Ten-year CSS and DFS rates for PTC patients <45 years old were 99.7 and 88.6 % in the classical PTC group and 100 and 60.5 % in the DSV group. CSS rate did not differ between groups, but DFS rate was significantly lower in the DSV group than in the classical PTC group (p < 0.0001, log-rank test). Multivariate analysis identified DSV group and pN1b as prognostic factors for recurrence in young PTC patients.

Conclusions

Most DSV patients were young and had a background of chronic thyroiditis. Outcomes for DSV were very good, but recurrence was more common than in classical PTC.
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Metadata
Title
Clinicopathologic Features and Outcomes in Patients with Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma
Authors
Junko Akaishi
Kiminori Sugino
Kaori Kameyama
Chie Masaki
Kenichi Matsuzu
Akifumi Suzuki
Takashi Uruno
Keiko Ohkuwa
Hiroshi Shibuya
Wataru Kitagawa
Mitsuji Nagahama
Kazuo Shimizu
Koichi Ito
Publication date
01-07-2015
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 7/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-015-3021-9

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