Management of follicular thyroid carcinoma should be individualised based on degree of capsular and vascular invasion

Follicular thyroid carcinoma (FTC) includes a spectrum of neoplasms with varying propensity for metastasis. The aim of this study is to describe outcomes for FTC following multimodality treatment, with particular reference to the degree of capsular and vascular invasion and to recommend a rational m...

Celý popis

Uložené v:
Podrobná bibliografia
Vydané v:European journal of surgical oncology Ročník 37; číslo 2; s. 181 - 185
Hlavní autori: O’Neill, C.J., Vaughan, L., Learoyd, D.L., Sidhu, S.B., Delbridge, L.W., Sywak, M.S.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: England Elsevier Ltd 01.02.2011
Predmet:
Adenocarcinoma
Adenocarcinoma, Follicular
Combined Modality Therapy
Disease-Free Survival
Female
Follicular
Hematology, Oncology and Palliative Medicine
Humans
Male
Middle Aged
Neoplasm Invasiveness
Surgery
Thyroid neoplasms
Thyroid Neoplasms - pathology
Thyroid Neoplasms - therapy
Thyroid nodule
Vascular Neoplasms - pathology
Adenocarcinoma
Thyroid neoplasms
Thyroid nodule
Follicular
ISSN:0748-7983, 1532-2157, 1532-2157
On-line prístup:Získať plný text
Tagy: Pridať tag
Žiadne tagy, Buďte prvý, kto otaguje tento záznam!
Popis
Shrnutí:Follicular thyroid carcinoma (FTC) includes a spectrum of neoplasms with varying propensity for metastasis. The aim of this study is to describe outcomes for FTC following multimodality treatment, with particular reference to the degree of capsular and vascular invasion and to recommend a rational management approach based on these characteristics. Patients with histologically confirmed FTC were identified from a prospectively maintained database. Details of intervention and long-term outcomes were obtained. Outcomes were compared between patients with minimally invasive follicular carcinoma (MI FTC) without vascular invasion (Group 1); angioinvasive MI FTC (Group 2); and those with widely invasive FTC (Group 3). Between May 1983 and December 2008, 124 patients with FTC were identified. The overall disease-free survival rate was 85% at a median of 40 months follow-up. Disease-free survival was 97%, 81% and 46%, respectively, in Groups 1, 2 and 3, and significantly different between groups ( p < 0.001). Thirteen patients in this series developed distant metastases including 2 in Group 1 and 6 in Group 2. Only patients <45 years of age with MI FTC and no vascular invasion had 100% disease-free survival. After multivariate linear regression, age ( p = 0.03) and the presence of vascular invasion ( p = 0.03) were the most powerful predictors of distant metastasis. Survival is improved in those with minimally invasive compared with widely invasive FTC. In patients <45 years with MI FTC without vascular invasion, hemithyroidectomy may be adequate treatment. All other patients with FTC should undergo total thyroidectomy and radioactive iodine ablation.
Bibliografia:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
ISSN:0748-7983
1532-2157
1532-2157
DOI:10.1016/j.ejso.2010.11.005