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Published in: Langenbeck's Archives of Surgery 4/2004

01-08-2004 | Original Article

The tall-cell variant of papillary thyroid carcinoma: a multivariate analysis of clinical risk factors

Authors: Andreas Machens, Hans-Jürgen Holzhausen, Christine Lautenschläger, Henning Dralle

Published in: Langenbeck's Archives of Surgery | Issue 4/2004

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Abstract

Background

The biological behaviour of the tall-cell variant (TCV) of papillary thyroid carcinoma (PTC) remains to be clarified in a multivariate analysis that controls for all relevant clinicopathological parameters.

Patients and methods

A retrospective analysis was carried out of 332 consecutive PTC patients operated on at a university hospital between November 1994 and February 2003.

Results

A total of 16 TCV tumours (4.8%) was identified among the 332 PTC patients. Nodal and (predominantly pulmonary) distant metastases were identified at surgery in, respectively, 50% and 31% of TCV tumours. On univariate analysis, only the association between the TCV and distant metastasis retained statistical significance after adjustment for multiple testing. On multivariate logistic regression analysis, the presence of distant metastasis increased more than fourfold [odds ratio (OR) 4.2] the chance of having the TCV of PTC, with controls for extrathyroidal extension, nodal metastasis, operation status, patient gender, categorized patient age, and categorized primary tumour diameter.

Conclusion

The increased risk of distant metastasis associated with the TCV morphology of PTC warrants an extensive post-operative search for distant metastasis to facilitate early diagnosis and treatment of tumour deposits in distant organs.
Literature
1.
go back to reference Hawk WA, Hazard JB (1976) The many appearances of papillary carcinoma of the thyroid. Cleve Clin Q 43:207–216PubMed Hawk WA, Hazard JB (1976) The many appearances of papillary carcinoma of the thyroid. Cleve Clin Q 43:207–216PubMed
2.
go back to reference Chan JKC (1990) Papillary carcinoma of thyroid: classical and variants. Histol Histopathol 5:241–257PubMed Chan JKC (1990) Papillary carcinoma of thyroid: classical and variants. Histol Histopathol 5:241–257PubMed
3.
go back to reference Moreno Egea A, Rodriguez Gonzalez JM, Sola Perez J, Soria Cogollos T, Parrilla Paricio P (1993) Prognostic value of the tall cell variety of papillary cancer of the thyroid. Eur J Surg Oncol 19:517–521PubMed Moreno Egea A, Rodriguez Gonzalez JM, Sola Perez J, Soria Cogollos T, Parrilla Paricio P (1993) Prognostic value of the tall cell variety of papillary cancer of the thyroid. Eur J Surg Oncol 19:517–521PubMed
4.
go back to reference Terry JH, St John SA, Karkowski FJ, Suarez JR, Yassa NH, Platica CD, Marti JR (1994) Tall cell papillary thyroid cancer: incidence and prognosis. Am J Surg 168:459–461PubMed Terry JH, St John SA, Karkowski FJ, Suarez JR, Yassa NH, Platica CD, Marti JR (1994) Tall cell papillary thyroid cancer: incidence and prognosis. Am J Surg 168:459–461PubMed
5.
go back to reference Ostrowski ML, Merino MJ (1996) Tall cell variant of papillary thyroid carcinoma: a reassessment and immunohistochemical study with comparison to the usual type of papillary carcinoma of the thyroid. Am J Surg Pathol 20:964–974CrossRefPubMed Ostrowski ML, Merino MJ (1996) Tall cell variant of papillary thyroid carcinoma: a reassessment and immunohistochemical study with comparison to the usual type of papillary carcinoma of the thyroid. Am J Surg Pathol 20:964–974CrossRefPubMed
6.
go back to reference Rüter A, Nishiyama R, Lennquist S (1997) Tall-cell variant of papillary thyroid cancer: disregarded entity? World J Surg 21:15–21CrossRefPubMed Rüter A, Nishiyama R, Lennquist S (1997) Tall-cell variant of papillary thyroid cancer: disregarded entity? World J Surg 21:15–21CrossRefPubMed
7.
go back to reference Prendiville S, Burman KD, Ringel MD, Shmookler BM, Deeb ZE, Wolfe K, Azumi N, Wartofsky L, Sessions RB (2000) Tall cell variant: an aggressive form of papillary thyroid carcinoma. Otolaryngol Head Neck Surg 122:352–357PubMed Prendiville S, Burman KD, Ringel MD, Shmookler BM, Deeb ZE, Wolfe K, Azumi N, Wartofsky L, Sessions RB (2000) Tall cell variant: an aggressive form of papillary thyroid carcinoma. Otolaryngol Head Neck Surg 122:352–357PubMed
8.
go back to reference Akslen LA, LiVolsi VA (2000) Prognostic significance of histologic grading compared with subclassification of papillary thyroid carcinoma. Cancer 88:1902–1908CrossRefPubMed Akslen LA, LiVolsi VA (2000) Prognostic significance of histologic grading compared with subclassification of papillary thyroid carcinoma. Cancer 88:1902–1908CrossRefPubMed
9.
go back to reference Machens A, Hinze R, Thomusch O, Dralle H (2002) Pattern of nodal metastasis for primary and reoperative thyroid cancer. World J Surg 26:22–28CrossRefPubMed Machens A, Hinze R, Thomusch O, Dralle H (2002) Pattern of nodal metastasis for primary and reoperative thyroid cancer. World J Surg 26:22–28CrossRefPubMed
10.
go back to reference Hinze R, Holzhausen HJ, Gimm O, Dralle H, Rath FW (1998) Primary hereditary medullary thyroid carcinoma—C-cell morphology and correlation with preoperative calcitonin levels. Virchows Arch 433:203–208CrossRefPubMed Hinze R, Holzhausen HJ, Gimm O, Dralle H, Rath FW (1998) Primary hereditary medullary thyroid carcinoma—C-cell morphology and correlation with preoperative calcitonin levels. Virchows Arch 433:203–208CrossRefPubMed
11.
go back to reference World Health Organization (1988) International histological classification of tumours. World Health Organization, Geneva, 2nd edn. Springer, Berlin World Health Organization (1988) International histological classification of tumours. World Health Organization, Geneva, 2nd edn. Springer, Berlin
12.
go back to reference Fleming ID, Cooper JS, Henson DE, Hutter RVP, Kennedy BJ, Murphy GP, O’Sullivan B, Sobin LH, Yabro JW (1997) AJCC cancer staging manual. American Joint Committee on Cancer, Philadelphia Fleming ID, Cooper JS, Henson DE, Hutter RVP, Kennedy BJ, Murphy GP, O’Sullivan B, Sobin LH, Yabro JW (1997) AJCC cancer staging manual. American Joint Committee on Cancer, Philadelphia
13.
go back to reference Sobin LH, Wittekind C (eds) (1997) TNM classification of malignant tumours, 5th edn. Wiley-Liss, New York Sobin LH, Wittekind C (eds) (1997) TNM classification of malignant tumours, 5th edn. Wiley-Liss, New York
14.
go back to reference Zhang J, Yu KF (1998) What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. J Am Med Assoc 280:1690–1691CrossRef Zhang J, Yu KF (1998) What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. J Am Med Assoc 280:1690–1691CrossRef
15.
go back to reference Johnson TL, Lloyd RV, Thompson NW, Beierwaltes WH, Sisson JC (1988) Prognostic implications of the tall cell variant of papillary thyroid carcinoma. Am J Surg Pathol 12:22–27PubMed Johnson TL, Lloyd RV, Thompson NW, Beierwaltes WH, Sisson JC (1988) Prognostic implications of the tall cell variant of papillary thyroid carcinoma. Am J Surg Pathol 12:22–27PubMed
16.
go back to reference Hennekens CH, Buring JE, Mayrent SL (eds) (1987) Epidemiology in medicine. Little, Brown, Boston Toronto Hennekens CH, Buring JE, Mayrent SL (eds) (1987) Epidemiology in medicine. Little, Brown, Boston Toronto
17.
go back to reference Machens A, Hinze R, Lautenschläger C, Dralle H (2001) Multivariate analysis of clinicopathologic parameters for the insular subtype of differentiated thyroid carcinoma. Arch Surg 136:941–944CrossRefPubMed Machens A, Hinze R, Lautenschläger C, Dralle H (2001) Multivariate analysis of clinicopathologic parameters for the insular subtype of differentiated thyroid carcinoma. Arch Surg 136:941–944CrossRefPubMed
18.
go back to reference van den Brekel MW, Hekkenberg RJ, Asa SL, Tomlinson G, Rosen IB, Freeman JL (1997) Prognostic features in tall cell papillary carcinoma and insular thyroid carcinoma. Laryngoscope 107:254–259CrossRefPubMed van den Brekel MW, Hekkenberg RJ, Asa SL, Tomlinson G, Rosen IB, Freeman JL (1997) Prognostic features in tall cell papillary carcinoma and insular thyroid carcinoma. Laryngoscope 107:254–259CrossRefPubMed
19.
go back to reference Filie AC, Chiesa A, Bryant BR, Merino MJ, Sobel ME, Abati A (1999) The tall cell variant of papillary carcinoma of the thyroid. Cytologic features and loss of heterozygosity of metastatic and/or recurrent neoplasms and primary neoplasms. Cancer (Cancer Cytopathol) 87:238–242 Filie AC, Chiesa A, Bryant BR, Merino MJ, Sobel ME, Abati A (1999) The tall cell variant of papillary carcinoma of the thyroid. Cytologic features and loss of heterozygosity of metastatic and/or recurrent neoplasms and primary neoplasms. Cancer (Cancer Cytopathol) 87:238–242
20.
go back to reference Grünwald F, Menzel C, Bender H, Palmedo H, Otte R, Fimmers R, Risse J, Biersack HJ (1998) Redifferentiation therapy-induced radioiodine uptake in thyroid cancer. J Nucl Med 39:1903–1906PubMed Grünwald F, Menzel C, Bender H, Palmedo H, Otte R, Fimmers R, Risse J, Biersack HJ (1998) Redifferentiation therapy-induced radioiodine uptake in thyroid cancer. J Nucl Med 39:1903–1906PubMed
21.
go back to reference Simon D, Koehrle J, Reiners C, Boerner AR, Schmutzler C, Mainz K, Goretzki PE, Roeher HD (1998) Redifferentiation therapy with retinoids: therapeutic option for advanced follicular and papillary thyroid carcinoma. World J Surg 22:569–574PubMed Simon D, Koehrle J, Reiners C, Boerner AR, Schmutzler C, Mainz K, Goretzki PE, Roeher HD (1998) Redifferentiation therapy with retinoids: therapeutic option for advanced follicular and papillary thyroid carcinoma. World J Surg 22:569–574PubMed
Metadata
Title
The tall-cell variant of papillary thyroid carcinoma: a multivariate analysis of clinical risk factors
Authors
Andreas Machens
Hans-Jürgen Holzhausen
Christine Lautenschläger
Henning Dralle
Publication date
01-08-2004
Publisher
Springer-Verlag
Published in
Langenbeck's Archives of Surgery / Issue 4/2004
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-004-0485-8

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