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Paper 23 (1300)
THE PROGNOSIS OF ONCOCYTIC (HURTHLE-CELL) FOLLICULAR THYROID CARCINOMA: IS IT DIFFERENT THAN ITS NON-ONCOCYTIC COUNTERPART?
Background: The prognosis of patients with oncocytic (Hurthle-cell) follicular thyroid carcinoma (OFTC) has been reported to be worse than non-OFTC. This population study compared the prognosis of OFTC and non-OFTC.
The 26th Annual Meeting of the American
Association of Endocrine Surgeons
April 3rd- 5th,2005 - Paradisus Riviera Cancun.
PI Haigh MD, DR Urbach MD;
Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA and University of Toronto, Toronto, Ontario
Methods: A US population database was used to identify patients with follicular thyroid carcinoma from 1988-1993 and follow-up to 2001. Survival of patients with OFTC was compared to non-OFTC; the effect of age, gender, tumor size, tumor extent, radioactive iodine and extent of thyroidectomy on survival was analyzed.
Results: There were 845 patients. Median follow-up was 9.4 years. 172 (20%) patients had OFTC and 673 (80%) had non-OFTC. Patients with OFTC were older, but there was no difference in tumor size or extent between OFTC and non-OFTC. Total thyroidectomy was performed in 80% of patients with OFTC compared to 69% with non-OFTC (p=0.005). Radioactive iodine was used in 33% with OFTC and 45% with non-OFTC (p=0.003). Overall survival for entire group was 81% at 10 years. The crude 10-year survival was 73% in patients with OFTC compared to 83% with non-OFTC, respectively (P=0.007). After adjusting for any independent effect on mortality, older age ( 50 vs. <50 years, HR=6.35, 95% CI 4.07 to 9.93), larger tumor size ( >5 cm vs =5 cm, HR=2.20, 95% CI 1.55 to 3.13; >10 cm vs =5 cm, HR=3.28, 95% CI 1.12 to 9.61), lymph node metastases (HR=3.11, 95% CI 1.80 to 5.37), and distant metastases (HR=3.91, 95% CI 1.94 to 7.90) were associated with higher mortality, whereas women (HR=0.48, 95% CI 0.36 to 0.66) had a lower mortality. Histology (non-OFTC vs. OFTC, HR=0.85, 95% CI 0.60 to 1.19), local extension, extent of thyroidectomy and radioactive iodine had no effect on mortality.
Conclusions: The prognosis of patients with OFTC in this large population was no different than those with non-OFTC after accounting for age, gender, tumor stage and treatment received. Histologic distinction between OFTC and non-OFTC is not as prognostically important as age, gender and tumor stage.