PMID- 23025507
OWN - NLM
STAT- MEDLINE
DCOM- 20130918
LR  - 20190221
IS  - 1557-9077 (Electronic)
IS  - 1050-7256 (Linking)
VI  - 23
IP  - 3
DP  - 2013 Mar
TI  - Risk stratification of follicular variant of papillary thyroid carcinoma.
PG  - 273-9
LID - 10.1089/thy.2012.0369 [doi]
AB  - BACKGROUND: Recent studies have described an encapsulated and an infiltrative 
      form of follicular variant of papillary thyroid carcinoma (FVPTC). While 
      encapsulated tumors have been reported to have virtually no metastatic potential 
      or recurrence risk if angioinvasion and capsular penetration are absent, 
      infiltrative tumors have been found to have a significant metastatic potential 
      and a risk of recurrence. In our experience, a substantial number of FVPTCs are 
      neither fully encapsulated nor infiltrative, but instead are 
      partially-encapsulated (PE) or well-circumscribed (WC). Thus, the aim of this 
      study was to investigate the metastatic potential and recurrence risk of PE/WC 
      FVPTCs in comparison with that of encapsulated and infiltrative tumors. METHODS: 
      We studied 77 FVPTCs resected between 2000 and 2002 and characterized the tumors 
      as encapsulated, PE/WC, or infiltrative. Histologic assessment was then 
      correlated with lymph node status and clinical outcome. RESULTS: In our cohort, 
      27 (35%) tumors were encapsulated, 35 (45%) were PE/WC, and 15 (19%) were 
      infiltrative. Lymph node status was similar between PE/WC and encapsulated 
      tumors, but was significantly different between encapsulated and infiltrative 
      groups (p<0.001), and PE/WC and infiltrative groups (p<0.001). Lymph node 
      metastases were absent in all 15 cases of encapsulated tumors and all 9 cases of 
      PE/WC tumors with sampled lymph nodes, but were present in 7 of 9 (78%) cases of 
      infiltrative tumors with sampled lymph nodes. For patients with available 
      clinical follow-up (66 cases, 86%), the median follow-up time was 111 months. No 
      patients with encapsulated tumors recurred, one (3%) patient with a PE/WC tumor 
      had recurrent/residual disease, and two (15%) patients with infiltrative tumors 
      had recurrent/residual disease. The one patient with a PE/WC tumor who had 
      recurrent/residual disease had a tumor bed recurrence 7 years after initial 
      resection. Significantly, this was the only patient in the PE/WC group that had a 
      positive resection margin. CONCLUSIONS: Our results demonstrate that PE/WC FVPTCs 
      have a very low metastatic potential/recurrence risk, indicating that they should 
      be distinguished from more aggressive infiltrative FVPTCs.
FAU - Vivero, Marina
AU  - Vivero M
AD  - Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 
      Boston, Massachusetts 02115, USA.
FAU - Kraft, Stefan
AU  - Kraft S
FAU - Barletta, Justine A
AU  - Barletta JA
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Thyroid
JT  - Thyroid : official journal of the American Thyroid Association
JID - 9104317
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma/*diagnosis/pathology/surgery
MH  - Carcinoma, Papillary
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Lymphatic Metastasis
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Metastasis
MH  - Recurrence
MH  - Risk Factors
MH  - Thyroid Cancer, Papillary
MH  - Thyroid Neoplasms/*diagnosis/pathology/surgery
MH  - Thyroidectomy/methods
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2012/10/03 06:00
MHDA- 2013/09/21 06:00
CRDT- 2012/10/03 06:00
PHST- 2012/10/03 06:00 [entrez]
PHST- 2012/10/03 06:00 [pubmed]
PHST- 2013/09/21 06:00 [medline]
AID - 10.1089/thy.2012.0369 [doi]
PST - ppublish
SO  - Thyroid. 2013 Mar;23(3):273-9. doi: 10.1089/thy.2012.0369.