Do histologically aggressive subtypes of papillary thyroid microcarcinoma have worse clinical outcome than non-aggressive rapillary thyroid microcarcinoma subtypes? A multicenter cohort study
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info:eu-repo/semantics/closedAccessTarih
2023Yazar
Zuhur, Sayid ShafiiAggül, Hünkar
Avcı, Uğur
Erol, Selvinaz
Tuna, Mazhar Müslüm
Uysal, Serhat
Akbaba, Gülhan
Kılınç, Faruk
Çatak, Merve
Tekin, Sakin
Bilen, Ogün İrem
Öztürk, Beyza Olcay
Erden, Ecem Bilgehan
Elbüken, Gülşah
Yavuz, Halise Çınar
Kadıoğlu, Pınar
Çınar, Neşe
Kutlutürk, Faruk
Bayraktaroğlu, Taner
Topçu, Birol
Arslan, Ayşegül Isal
Güçer, Hasan
Cihangiroğlu, Gülçin
Topal, Cumhur Selçuk
Öztürk, Tülin
Tekin, Leyla
Artaş, Gökhan
Akçay, Elif
Gün, Banu Doğan
Altuntaş, Yüksel
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Zuhur, S. S., Aggul, H., Avci, U., Erol, S., Tuna, M. M., Uysal, S., Akbaba, G., Kilinç, F., Catak, M., Tekin, S., Bilen, O. I., Öztürk, B. O., Erden, E. B., Elbuken, G., Yavuz, H. C., Kadioglu, P., Cinar, N., Kutluturk, F., Bayraktaroglu, T., Topçu, B., … Altuntas, Y. (2023). Do Histologically Aggressive Subtypes of Papillary Thyroid Microcarcinoma have Worse Clinical Outcome than Non-Aggressive Papillary Thyroid Microcarcinoma Subtypes? A Multicenter Cohort Study. Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme, 55(5), 323–332. https://doi.org/10.1055/a-2032-5810Özet
Histologically aggressive micropapillary thyroid carcinomas (PTMC) subtypes are thought to be associated with an aggressive clinical course. However, evidence for unfavorable clinical outcomes in patients with aggressive PTMC subtypes is not clear. In this study, we intended to determine the difference in clinical outcomes between patients with aggressive and non-aggressive PTMC subtypes. In this multicenter cohort study, the computer-recorded clinical and histopathological data of patients who underwent thyroid surgery between January 2000 - January 2021 in 9 referral centers and were diagnosed as PTMC were analyzed. A total of 1585 patients [female 1340 (84.5%), male 245 (15.5%), mean age 47.9 +/- 11.63 years), with a mean follow-up time of 66.55 +/- 37.16 months], were included in the study. Ninety-eight cases were diagnosed as aggressive and 1487 as non-aggressive subtypes. Persistent/recurrent disease was observed in 33 (33.7% )and 41 (2.8%) patients with aggressive and non-aggressive subtypes (p < 0.001). Diseases-free survival rates were markedly lower in patients with aggressive than in those with non-aggressive PTMC subtypes (66.3 vs. 94.8%, log-rank p < 0.001). Moreover, in multivariate analysis, aggressive histology was an independent predictor of persistent/recurrent disease, after controlling for other contributing factors (HR 5.78, 95% CI 3.32-10, p < 0.001). Patients with aggressive PTMC subtypes had higher rates of incomplete biochemical and structural response than patients with non-aggressive subtypes as well (p < 0.001). Aggressive PTMC subtypes share many characteristics with histologically identical tumors > 1 cm in size. Therefore, the histopathological subtype of PTMC should be taken into consideration to tailor a personalized management plan.