Classical and Follicular Variant of Papillary Thyroid Carcinoma: A Comparative Study on Clinicopathologic Features and Long‐term Outcome

作者：Brian Hung‐Hin Lang, Chung‐Yau Lo, Wai-Fan Chan, Alfred King-yin Lam, Koon Yat Wan · 发表于：World Journal of Surgery · 年份：2006 · DOI：10.1007/s00268-005-0356-7 · 被引用次数：112 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Thyroid and Parathyroid Surgery、Thyroid Disorders and Treatments

INTRODUCTION: The follicular variant of papillary thyroid carcinoma (FVPTC) is the most common histologic subtype of papillary thyroid carcinoma (PTC). However, it is still controversial whether FVPTC should behave differently from classical PTC (CPTC). The present study aimed at evaluating any potential difference in clinicopathologic features and long-term outcome of FVPTC as compared with CPTC. PATIENTS AND METHODS: Of 568 patients with PTC managed from 1973 to 2004, 308 were shown to have CPTC (54.2%) and 67 (11.8%) FVPTC after histologic review. The mean (+/- SD) follow-up period was 11.3 (+/- 8.9) years. The two groups were compared in terms of clinicopathological features, treatment received, and outcome regarding recurrence and disease-specific survival. RESULTS: There was no difference in age and gender ratio between the CPTC and FVPTC patients. Both groups had similar tumor characteristics in terms of tumor size, presence of multifocality, capsular invasion, lymphovascular permeation, and perineural infiltration. However, FVPTC patients had significantly fewer histologically confirmed cervical lymph node metastases (P = 0.027) and extrathyroidal involvement (P = 0.005). The proportion of bilateral resection, adjuvant radioactive iodine, and lymph node dissection did not differ significantly between the two groups. The FVPTC patients had a more favorable tumor risk by DeGroot classification (P = 0.003) and MACIS (Metastasis, Age, Completeness of excision, Invasivenes...