Download PDF
Horm Metab Res 2023; 55(12): 855-868
DOI: 10.1055/a-2177-3413
Original Article: Endocrine Care

Comparison of Treatment and Prognosis Between Follicular Variant Papillary Thyroid Carcinoma and Classical Papillary Thyroid Carcinoma

Bing Zhang
1   Zhantansi Outpatient, Central Medical District of Chinese PLA General Hospital, Beijing, China
,
Wenming Wu
2   College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
,
Jinjing Liu
2   College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
,
Zhou Liang
1   Zhantansi Outpatient, Central Medical District of Chinese PLA General Hospital, Beijing, China
,
Liang Zong
2   College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

This cohort study evaluated the associations of different treatments with the prognosis of follicular variant papillary thyroid carcinoma (FVPTC) and classical papillary thyroid carcinoma (CPTC) patients. The data of 69034 PTC patients were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. The 5-year mortality of CPTC and FVPTC patients receiving surgery, radiation and combination therapy were compared. The univariable and multivariable cox proportional risk models explored the associations between different treatments and the 5-year mortality in CPTC and FVPTC patients. The 5-year mortality of CPTC patients was 2.81% and FVPTC patients was 2.47%. Compared with CPTC receiving lobectomy and/or isthmectomy, those not receiving surgery were associated with increased risk of 5-year mortality [Hazards ratio (HR)=3.27, 95% confidence interval (CI): 2.55–4.20] while total thyroidectomy was correlated with reduced risk of 5-year mortality (HR=0.67, 95%CI: 0.55–0.80). Radioactive iodine (RAI) was linked with decreased risk of 5-year mortality in CPTC patients (HR=0.57, 95%CI: 0.50–0.65). CPTC patients undergoing both surgery and radiation were related to decreased risk of 5-year mortality compared with those receiving surgery only (HR=0.55, 95%CI: 0.48–0.63). CPTC patients receiving neither surgery nor radiation (HR=4.53, 95%CI: 3.72–5.51) or those receiving radiation (HR=1.98, 95%CI: 1.13–3.48) were correlated with elevated risk of 5-year mortality. The elevated risk of 5-year mortality in FVPTC patients was reduced in those undergoing RAI (HR=0.63, 95%CI: 0.51–0.76). In conclusion, combination therapy was associated with decreased risk of 5-year mortality in CPTC and FVPTC patients, which might provide a reference for the management of these patients.

Key words

follicular variant papillary thyroid carcinoma - classical papillary thyroid carcinoma - surgery - radiation

Supplementary Material



Publication History

Received: 12 July 2023

Accepted after revision: 06 September 2023

Article published online:
09 October 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Shao C, Li Z, Zhang C. et al. Optical diagnostic imaging and therapy for thyroid cancer. Mater Today Bio 2022; 17: 100441
    CrossrefPubMedGoogle Scholar
  • 2 Issa PP, Albuck AL, Hossam E. et al. The diagnostic performance of ultrasonography in the evaluation of extrathyroidal extension in papillary thyroid carcinoma: a systematic review and meta-analysis. Int J Mol Sci 2022; 24
    PubMedGoogle Scholar
  • 3 Jung CK, Bychkov A, Kakudo K. Update from the 2022 World Health Organization classification of thyroid tumors: a standardized diagnostic approach. Endocrinol Metab (Seoul, Korea) 2022; 37: 703-718
    CrossrefPubMedGoogle Scholar
  • 4 Mao Y, Xing M. Recent incidences and differential trends of thyroid cancer in the USA. Endocr Relat Cancer 2016; 23: 313-322
    CrossrefPubMedGoogle Scholar
  • 5 Henke LE, Pfeifer JD, Baranski TJ. et al. Long-term outcomes of follicular variant vs classic papillary thyroid carcinoma. Endocr Connect 2018; 7: 1226-1235
    CrossrefPubMedGoogle Scholar
  • 6 Tunca F, Sormaz IC, Iscan Y. et al. Comparison of histopathological features and prognosis of classical and follicular variant papillary thyroid carcinoma. J Edocrinol Invest 2015; 38: 1327-1334
    CrossrefPubMedGoogle Scholar
  • 7 Raffaelli M, Tempera SE, Sessa L. et al. Total thyroidectomy versus thyroid lobectomy in the treatment of papillary carcinoma. Gland Surg 2020; 9: S18-S27
    CrossrefPubMedGoogle Scholar
  • 8 Tang J, Kong D, Bu L. et al. Surgical management for follicular variant of papillary thyroid carcinoma. Oncotarget 2017; 8: 79507-79516
    CrossrefPubMedGoogle Scholar
  • 9 Sun Y, Gong J, Guo B. et al. Association of adjuvant radioactive iodine therapy with survival in node-positive papillary thyroid cancer. Oral Oncol 2018; 87: 152-157
    CrossrefPubMedGoogle Scholar
  • 10 Fujiwara T, Yoshizawa A, Mizuta M. et al. Is surgical resection without radioactive iodine treatment a safe alternative treatment for T1-2N1bM0 papillary thyroid carcinoma?. Auris Nasus Larynx 2021; 48: 148-153
    CrossrefPubMedGoogle Scholar
  • 11 Simões-Pereira J, Mourinho N, Ferreira TC. et al. Avidity and outcomes of radioiodine therapy for distant metastasis of distinct types of differentiated thyroid cancer. J Clin Endocrinol Metab 2021; 106: e3911-e3922
    CrossrefPubMedGoogle Scholar
  • 12 Wang X, Zheng X, Zhu J. et al. Radioactive iodine therapy may not improve disease-specific survival in follicular variant papillary thyroid cancer without distant metastasis: a propensity score-matched analysis. Head Neck 2021; 43: 1730-1738
    CrossrefPubMedGoogle Scholar
  • 13 Chen J, Chen Q, Deng Y. et al. Development and validation of prognostic nomograms for periampullary neuroendocrine neoplasms: a SEER database analysis. Curr Oncol (Toronto, Ont) 2022; 30: 344-357
    CrossrefPubMedGoogle Scholar
  • 14 Zhang D, Tang J, Kong D. et al. Impact of gender and age on the prognosis of differentiated thyroid carcinoma: a retrospective analysis based on SEER. Horm Cancer 2018; 9: 361-370
    CrossrefPubMedGoogle Scholar
  • 15 Lang BH, Lo CY, Chan WF. et al. 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
    CrossrefPubMedGoogle Scholar
  • 16 Suman P, Razdan SN, Wang CE. et al. Thyroid lobectomy for T1b-T2 papillary thyroid cancer with high-risk features. J Am College Surg 2020; 230: 136-144
    CrossrefPubMedGoogle Scholar
  • 17 Wu Z, Han L, Li W. et al. Which is preferred for initial treatment of papillary thyroid cancer, total thyroidectomy or lobotomy?. Cancer Med 2021; 10: 1614-1622
    CrossrefPubMedGoogle Scholar
  • 18 Vasileiadis I, Boutzios G, Karalaki M. et al. Papillary thyroid carcinoma of the isthmus: total thyroidectomy or isthmusectomy?. Am J Surg 2018; 216: 135-139
    CrossrefPubMedGoogle Scholar
  • 19 Wang X, Zhu J, Li Z. et al. The benefits of radioactive iodine ablation for patients with intermediate-risk papillary thyroid cancer. PloS One 2020; 15: e0234843
    CrossrefPubMedGoogle Scholar
  • 20 Ruel E, Thomas S, Dinan M. et al. Adjuvant radioactive iodine therapy is associated with improved survival for patients with intermediate-risk papillary thyroid cancer. J Clin Endocrinol Metab 2015; 100: 1529-1536
    CrossrefPubMedGoogle Scholar
  • 21 Tian T, Qi Z, Huang S. et al. Radioactive iodine therapy decreases the recurrence of intermediate-risk PTC with low thyroglobulin levels. J Clin Endocrinol Metab 2023; 108: 2033-2041
    CrossrefPubMedGoogle Scholar
  • 22 Sun YQ, Sun D, Zhang X. et al. Radioiodine adjuvant therapy in differentiated thyroid cancer: an update and reconsideration. Front Endocrinol 2022; 13: 994288
    CrossrefPubMedGoogle Scholar
  • 23 Haugen BR, Alexander EK, Bible KC. et al. 2015; American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016; 26: 1-133
    CrossrefPubMedGoogle Scholar
  • 24 MacKinney EC, Kuchta KM, Winchester DJ. et al. Overall survival is improved with total thyroidectomy and radiation for male patients and patients older than 55 with T2N0M0 Stage 1 classic papillary thyroid cancer. Surgery 2022; 171: 197-202
    CrossrefPubMedGoogle Scholar
  • 25 Holoubek SA, MacKinney EC, Khokar AM. et al. Radioactive iodine does not improve overall survival for patients with aggressive variants of papillary thyroid carcinoma less than 2 cm. Surgery 2022; 171: 203-211
    CrossrefPubMedGoogle Scholar