Skip to main content
Top
Published in: Thyroid Research 1/2011

Open Access 01-12-2011 | Research

Histological subtype is the most important determinant of survival in metastatic papillary thyroid cancer

Authors: Alexandra Chrisoulidou, Maria Boudina, Athanasios Tzemailas, Eleni Doumala, Pashalia K Iliadou, Frideriki Patakiouta, Kalliopi Pazaitou-Panayiotou

Published in: Thyroid Research | Issue 1/2011

Login to get access

Abstract

Background

Papillary thyroid cancer (PTC) comprises the commonest type of thyroid cancer and carries the highest rate of survival. However, when metastatic disease occurs, survival is significantly affected.

Methods

We aimed to identify prognostic histopathological and clinical factors that modify survival in metastatic PTC. All cases of metastatic PTC treated at our department in the last 20 years were reviewed and analyzed.

Results

Histological subtype was the most important determinant of survival, as classic PTC demonstrated clearly improved survival compared to follicular subtype of PTC and other less frequently seen histological subtypes. The instant risk of death for the other histological subtypes was 4.56 times higher than the risk for the classic papillary type. Overall, a 10-year survival of 76.6% in our patients was seen.

Conclusions

Patients with aggressive variants of PTC are more at risk for the development of metastatic disease. In these patients, established treatment modalities (surgery, radioiodine therapy) should be offered promptly, as well as close follow-up.
Appendix
Available only for authorised users
Literature
1.
go back to reference Salter KD, Andersen PE, Cohen JI, Schuff KG, Lester L, Shindo ML, Sauer D, Gross ND: Central node metastases in papillary thyroid carcinoma based on tumor histologic type and focality. Arch Otolaryngol Head Neck Surg 2010, 136: 692–696. 10.1001/archoto.2010.112CrossRefPubMed Salter KD, Andersen PE, Cohen JI, Schuff KG, Lester L, Shindo ML, Sauer D, Gross ND: Central node metastases in papillary thyroid carcinoma based on tumor histologic type and focality. Arch Otolaryngol Head Neck Surg 2010, 136: 692–696. 10.1001/archoto.2010.112CrossRefPubMed
2.
go back to reference Maxon HR, Smith HS: Radioiodine-131 in the diagnosis and treatment of metastatic well-differentiated thyroid cancer. Endocrinol Metab Clin North Am 1990, 19: 685–671.PubMed Maxon HR, Smith HS: Radioiodine-131 in the diagnosis and treatment of metastatic well-differentiated thyroid cancer. Endocrinol Metab Clin North Am 1990, 19: 685–671.PubMed
3.
go back to reference Sugitani I, Fujomoto Y, Yamamoto N: Papillary thyroid cancer with distant metastases:survival predictors and the importance of local control. Surgery 2008, 143: 35–42. 10.1016/j.surg.2007.06.011CrossRefPubMed Sugitani I, Fujomoto Y, Yamamoto N: Papillary thyroid cancer with distant metastases:survival predictors and the importance of local control. Surgery 2008, 143: 35–42. 10.1016/j.surg.2007.06.011CrossRefPubMed
4.
go back to reference Lang BH-H, Lo CY, Chan WF, Lam AK, Wan KY: Classical and follicular variant of papillary thyroid carcinoma: a comparative study on clinicopathologic features and long-term outcome. World J Surg 2006, 30: 752–758. 10.1007/s00268-005-0356-7CrossRefPubMed Lang BH-H, Lo CY, Chan WF, Lam AK, Wan KY: Classical and follicular variant of papillary thyroid carcinoma: a comparative study on clinicopathologic features and long-term outcome. World J Surg 2006, 30: 752–758. 10.1007/s00268-005-0356-7CrossRefPubMed
5.
go back to reference Lin JD, Chao TC, Chou SC, Hsueh C: Papillary thyroid carcinomas with lung metastases. Thyroid 2004, 14: 1091–1096. 10.1089/thy.2004.14.1091CrossRefPubMed Lin JD, Chao TC, Chou SC, Hsueh C: Papillary thyroid carcinomas with lung metastases. Thyroid 2004, 14: 1091–1096. 10.1089/thy.2004.14.1091CrossRefPubMed
6.
go back to reference Do MY, Rhee Y, Kim DJ, Kim CS, Nam KH, Ahn CW, Cha BA, Kim KR, Lee HC, Park CS, Lim SK: Clinical features of bone metastases resulting from thyroid cancer: a review of 28 patients over a 20-year period. Endocr J 2005, 52: 701–707. 10.1507/endocrj.52.701CrossRefPubMed Do MY, Rhee Y, Kim DJ, Kim CS, Nam KH, Ahn CW, Cha BA, Kim KR, Lee HC, Park CS, Lim SK: Clinical features of bone metastases resulting from thyroid cancer: a review of 28 patients over a 20-year period. Endocr J 2005, 52: 701–707. 10.1507/endocrj.52.701CrossRefPubMed
7.
go back to reference Parker LN, Wu SY, Kim DD, Kollin J, Prasasvinichai S: Recurrence of papillary thyroid carcinoma presenting as focal neurologic deficit. Arch Intern Med 1986, 146: 1985–1987. 10.1001/archinte.146.10.1985CrossRefPubMed Parker LN, Wu SY, Kim DD, Kollin J, Prasasvinichai S: Recurrence of papillary thyroid carcinoma presenting as focal neurologic deficit. Arch Intern Med 1986, 146: 1985–1987. 10.1001/archinte.146.10.1985CrossRefPubMed
8.
go back to reference Holmquest DL, Lake P: Sudden hemorrhage in metastatic thyroid carcinoma of the brain during treatment with iodine-131. J Nucl Med 1976, 17: 307–309.PubMed Holmquest DL, Lake P: Sudden hemorrhage in metastatic thyroid carcinoma of the brain during treatment with iodine-131. J Nucl Med 1976, 17: 307–309.PubMed
9.
go back to reference Agriantonis DJ, Hall L, Wilson MA: Utility of SPECT/CT as an adjunct planar whole body I-131 imaging: liver metastases from papillary thyroid cancer. Clin Nucl Med 2009, 34: 247–248. 10.1097/RLU.0b013e31819a1eb3CrossRefPubMed Agriantonis DJ, Hall L, Wilson MA: Utility of SPECT/CT as an adjunct planar whole body I-131 imaging: liver metastases from papillary thyroid cancer. Clin Nucl Med 2009, 34: 247–248. 10.1097/RLU.0b013e31819a1eb3CrossRefPubMed
10.
go back to reference Mizukami Y, Michigishi T, Nonomura A, Hashimoto T, Terahata S, Nogushi M, Hisada K, Matsubara F: Distant metastases differentiated thyroid carcinomas: a clinical and pathologic study. Hum Pathol 1990, 21: 283–290. 10.1016/0046-8177(90)90228-WCrossRefPubMed Mizukami Y, Michigishi T, Nonomura A, Hashimoto T, Terahata S, Nogushi M, Hisada K, Matsubara F: Distant metastases differentiated thyroid carcinomas: a clinical and pathologic study. Hum Pathol 1990, 21: 283–290. 10.1016/0046-8177(90)90228-WCrossRefPubMed
11.
go back to reference Sardi A, Agnone DM, Pellegrini A: Renal metastasis from papillary thyroid cancer. J Louisiana State Med Soc 1992, 144: 416–420. Sardi A, Agnone DM, Pellegrini A: Renal metastasis from papillary thyroid cancer. J Louisiana State Med Soc 1992, 144: 416–420.
12.
go back to reference Borschitz T, Eichhorn W, Fottner C, Hansen T, Schad A, Schadmand-Fischer S, Weber MM, Schreckenberger M, Lang H, Musholt TJ: Diagnosis and treatment of pancreatic metastases of a papillary thyroid carcinoma. Thyroid 2010, 20: 93–98. 10.1089/thy.2009.0026PubMedCentralCrossRefPubMed Borschitz T, Eichhorn W, Fottner C, Hansen T, Schad A, Schadmand-Fischer S, Weber MM, Schreckenberger M, Lang H, Musholt TJ: Diagnosis and treatment of pancreatic metastases of a papillary thyroid carcinoma. Thyroid 2010, 20: 93–98. 10.1089/thy.2009.0026PubMedCentralCrossRefPubMed
13.
go back to reference Bruglia M, Palmonella G, Silvetti F, Rutigliano P, Criante P, Marmorale C, Boscaro M, Taccaliti A: Skin and thigh muscle metastasis from papillary thyroid carcinoma. Singapore Med J 2009, 50: 61–64. Bruglia M, Palmonella G, Silvetti F, Rutigliano P, Criante P, Marmorale C, Boscaro M, Taccaliti A: Skin and thigh muscle metastasis from papillary thyroid carcinoma. Singapore Med J 2009, 50: 61–64.
14.
go back to reference Klubo-Gwiezdzinska J, Morowitz D, Van Nortrand D, Burman KD, Vasko V, Chia S, Deng T, Kulkarni K, Wartofsky L: Metastases of well-differentiated thyroid cancer to the gastrointestinal tract. Thyroid 2010, 20: 381–387. 10.1089/thy.2009.0280CrossRefPubMed Klubo-Gwiezdzinska J, Morowitz D, Van Nortrand D, Burman KD, Vasko V, Chia S, Deng T, Kulkarni K, Wartofsky L: Metastases of well-differentiated thyroid cancer to the gastrointestinal tract. Thyroid 2010, 20: 381–387. 10.1089/thy.2009.0280CrossRefPubMed
15.
go back to reference Showalter TN, Siegel BA, Moley JF, Baranski TJ, Grisby PW: Prognostic factors in patients with well-differentiated thyroid cancer presenting with pulmonary metastasis. Cancer Biother Radiopharm 2008, 23: 655–659. 10.1089/cbr.2008.0501CrossRefPubMed Showalter TN, Siegel BA, Moley JF, Baranski TJ, Grisby PW: Prognostic factors in patients with well-differentiated thyroid cancer presenting with pulmonary metastasis. Cancer Biother Radiopharm 2008, 23: 655–659. 10.1089/cbr.2008.0501CrossRefPubMed
16.
go back to reference Benbassat CA, Mechlis-Frish S, Hirsch D: Clinicopathological characteristics and long-term outcome in patients with distant metastases from differentiated thyroid cancer. World J Surg 2006, 30: 1088–1095. 10.1007/s00268-005-0472-4CrossRefPubMed Benbassat CA, Mechlis-Frish S, Hirsch D: Clinicopathological characteristics and long-term outcome in patients with distant metastases from differentiated thyroid cancer. World J Surg 2006, 30: 1088–1095. 10.1007/s00268-005-0472-4CrossRefPubMed
17.
go back to reference De Lellis RA, Lloyd RV, Heinz PU, Eng C, editors: World Health Organization Classification of Tumours.Pathology and Genetics-Tumours of Endocrine Organs. In IARC Press. Lyon; 2004. De Lellis RA, Lloyd RV, Heinz PU, Eng C, editors: World Health Organization Classification of Tumours.Pathology and Genetics-Tumours of Endocrine Organs. In IARC Press. Lyon; 2004.
18.
go back to reference Roti E, Rossi R, Trasforini G, Bertelli F, Ambrosio MR, Busutti L, Pearce EN, Braverman LE, Degli Uberti EC: Clinical and histological characteristics of papillary thyroid microcarcinoma: results of a retrospective study in 243 patients. J Clin Endocrinol Metab 2006, 91: 2171–2178. 10.1210/jc.2005-2372CrossRefPubMed Roti E, Rossi R, Trasforini G, Bertelli F, Ambrosio MR, Busutti L, Pearce EN, Braverman LE, Degli Uberti EC: Clinical and histological characteristics of papillary thyroid microcarcinoma: results of a retrospective study in 243 patients. J Clin Endocrinol Metab 2006, 91: 2171–2178. 10.1210/jc.2005-2372CrossRefPubMed
19.
go back to reference Pellegriti G, Scollo C, Lumera G, Regalbuto C, Vigneri R, Belfiore A: Clinical behaviour and outcome of papillary thyroid cancers smaller than 1.5 cm in diameter: study of 299 cases. J Clin Endocrinol Metab 2004, 89: 3713–3720. 10.1210/jc.2003-031982CrossRefPubMed Pellegriti G, Scollo C, Lumera G, Regalbuto C, Vigneri R, Belfiore A: Clinical behaviour and outcome of papillary thyroid cancers smaller than 1.5 cm in diameter: study of 299 cases. J Clin Endocrinol Metab 2004, 89: 3713–3720. 10.1210/jc.2003-031982CrossRefPubMed
20.
go back to reference Dinneen SF, Valimaki MJ, Bergstralh EJ, Goellner JR, Gorman CA, Hay ID: Distant metastases in papillary thyroid carcinoma: 100 cases observed at one institution during 5 decades. J Clin Endocrinol Metab 1995, 80: 2041–2045. 10.1210/jc.80.7.2041PubMed Dinneen SF, Valimaki MJ, Bergstralh EJ, Goellner JR, Gorman CA, Hay ID: Distant metastases in papillary thyroid carcinoma: 100 cases observed at one institution during 5 decades. J Clin Endocrinol Metab 1995, 80: 2041–2045. 10.1210/jc.80.7.2041PubMed
21.
go back to reference Durante C, Haddy N, Baudin E, Leboulleux S, Hartl D, Travagli JP, Caillou B, Ricard M, Lumbroso JD, De Vathaire F, Schlumberger M: Long-term outcome of 444 patients with distant metastases from papillary and follicular thyroid carcinoma:benefits and limits of radioiodine therapy. J Clin Endocrinol Metab 2006, 91: 2892–2899. 10.1210/jc.2005-2838CrossRefPubMed Durante C, Haddy N, Baudin E, Leboulleux S, Hartl D, Travagli JP, Caillou B, Ricard M, Lumbroso JD, De Vathaire F, Schlumberger M: Long-term outcome of 444 patients with distant metastases from papillary and follicular thyroid carcinoma:benefits and limits of radioiodine therapy. J Clin Endocrinol Metab 2006, 91: 2892–2899. 10.1210/jc.2005-2838CrossRefPubMed
22.
go back to reference Ito Y, Masuoka H, Fukushima M, Inoue H, Kihara M, Tomoda C, Higashiyama T, Takamura Y, Kobayashi K, Miya A, Miyauchi A: Prognosis and prognostic factors of patients with papillary carcinoma showing distant metastasis at surgery. Endocr J 2010, 57: 523–531. 10.1507/endocrj.K10E-019CrossRefPubMed Ito Y, Masuoka H, Fukushima M, Inoue H, Kihara M, Tomoda C, Higashiyama T, Takamura Y, Kobayashi K, Miya A, Miyauchi A: Prognosis and prognostic factors of patients with papillary carcinoma showing distant metastasis at surgery. Endocr J 2010, 57: 523–531. 10.1507/endocrj.K10E-019CrossRefPubMed
23.
go back to reference Kakudo K, Tang W, Ito Y, Nakamura Y, Yasuoka H, Morita S, Miyauchi A: Papillary carcinoma of the thyroid in Japan: subclassification of common type and identification of low risk group. J Clin Pathol 2004, 57: 1041–1046. 10.1136/jcp.2004.017889PubMedCentralCrossRefPubMed Kakudo K, Tang W, Ito Y, Nakamura Y, Yasuoka H, Morita S, Miyauchi A: Papillary carcinoma of the thyroid in Japan: subclassification of common type and identification of low risk group. J Clin Pathol 2004, 57: 1041–1046. 10.1136/jcp.2004.017889PubMedCentralCrossRefPubMed
24.
go back to reference Mercante G, Frasoldati A, Pedroni C, Formisano D, Renna L, Piana S, Gardini G, Valcani R, Barbieri V: Prognostic factors affecting neck lymph node recurrence and distant metastasis in papillary microcarcinoma of the thyroid:results of a study in 445 patients. Thyroid 2009, 19: 707–716. 10.1089/thy.2008.0270CrossRefPubMed Mercante G, Frasoldati A, Pedroni C, Formisano D, Renna L, Piana S, Gardini G, Valcani R, Barbieri V: Prognostic factors affecting neck lymph node recurrence and distant metastasis in papillary microcarcinoma of the thyroid:results of a study in 445 patients. Thyroid 2009, 19: 707–716. 10.1089/thy.2008.0270CrossRefPubMed
25.
go back to reference Baek SK, Jung KY, Kang SM, Kwon SY, Woo JS, Cho SH, Chung EJ: Clinical risk factors associated with cervical lymph node recurrence in papillary thyroid carcinoma. Thyroid 2010, 20: 147–152. 10.1089/thy.2008.0243CrossRefPubMed Baek SK, Jung KY, Kang SM, Kwon SY, Woo JS, Cho SH, Chung EJ: Clinical risk factors associated with cervical lymph node recurrence in papillary thyroid carcinoma. Thyroid 2010, 20: 147–152. 10.1089/thy.2008.0243CrossRefPubMed
26.
go back to reference Sebastian SO, Gonzalez JM, Paricio PP, Perez JS, Flores DP, Madrona AP, Romero PR, Tebar FJ: Papillary thyroid carcinoma:prognostic index for survival including the histologic variety. Arch Surg 2000, 135: 272–277. 10.1001/archsurg.135.3.272CrossRefPubMed Sebastian SO, Gonzalez JM, Paricio PP, Perez JS, Flores DP, Madrona AP, Romero PR, Tebar FJ: Papillary thyroid carcinoma:prognostic index for survival including the histologic variety. Arch Surg 2000, 135: 272–277. 10.1001/archsurg.135.3.272CrossRefPubMed
Metadata
Title
Histological subtype is the most important determinant of survival in metastatic papillary thyroid cancer
Authors
Alexandra Chrisoulidou
Maria Boudina
Athanasios Tzemailas
Eleni Doumala
Pashalia K Iliadou
Frideriki Patakiouta
Kalliopi Pazaitou-Panayiotou
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Thyroid Research / Issue 1/2011
Electronic ISSN: 1756-6614
DOI
https://doi.org/10.1186/1756-6614-4-12

Other articles of this Issue 1/2011

Thyroid Research 1/2011 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.