Clinical impact of follicular oncocytic (Hürthle cell) carcinoma in comparison to corresponding classical follicular thyroid carcinoma

Ziel/Aim There are controversial debates if patients with Hürthle cell carcinoma, also known as oxyphilic or oncocytic cell follicular thyroid carcinoma, have a poorer outcome. In this study, we systematically evaluated the clinical outcome in a large patient cohort following surgery and adjuvant I¹³¹ radioactive iodine therapy.

Methodik/Methods We retrospectively evaluated a total of 378 patients with diagnosed follicular Hürthle cell carcinoma (N = 127) or with classical follicular thyroid carcinoma (N = 253). Patients received thyroidectomy and complementary adjuvant I¹³¹ radioactive iodine therapy (RIT). Clinical data regarding basic demographic characteristics, tumor grade, persistent disease and recurrence during follow-up, progression-free, disease-specific and overall survival were collected. Recurrence rate and disease-free survival was evaluated in patients with no evidence of disease in the 1^st control after RIT. Furthermore, patients were matched to exclude influence on survival in a subgroup analysis.

Ergebnisse/Results Recurrence was significantly more often detected in OFTC patients (N = 16/92, 17 %) than in FTC patients (N = 12/150, 8 %; p-value 0.037). Mean disease-free survival was 17.9 years (16.0–19.8) in OFTC and 20.1 years (19.0–21.1) in FTC patients (p-value 0.027). At the end of follow-up, 22 % of OFTC patients (N = 28/126) and 29 % of FTC patients (N = 73/252) had evidence of disease (p-value 0.177). Mean disease-specific survival was 19.9 years (18.6–21.3) in the OFTC group and 18.5 years (17.3–19.8) in the FTC group (p-value 0.671).

Schlussfolgerungen/Conclusions OFTC has a higher risk for recurrence and disease-free survival was reduced. However, disease-specific mortality is still rare and not worse than in FTC patients.