World Journal of Endocrine Surgery

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VOLUME 15 , ISSUE 3 ( September-December, 2023 ) > List of Articles

Original Article

Long-term Outcome of Follicular Thyroid Carcinoma: A Retrospective Cohort Study on 10-year Outcome of Follicular Thyroid Carcinoma

Sidhu R Sekhar, Revathy Ajayachandran K Nair, Misha JC Babu, Gopalakrishnan Nair, Riju R Menon, Pradeep Jacob, Anoop V Pillai

Keywords : Differentiated thyroid cancer, Distant metastasis, Follicular thyroid carcinoma

Citation Information : Sekhar SR, Nair RA, Babu MJ, Nair G, Menon RR, Jacob P, Pillai AV. Long-term Outcome of Follicular Thyroid Carcinoma: A Retrospective Cohort Study on 10-year Outcome of Follicular Thyroid Carcinoma. World J Endoc Surg 2023; 15 (3):71-75.

DOI: 10.5005/jp-journals-10002-1465

License: CC BY-NC 4.0

Published Online: 20-04-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Papillary thyroid cancer (PTC) is the most common subtype of differentiated thyroid cancer and shows an increase in incidence globally. However, follicular thyroid carcinoma shows a decreasing trend in incidence but has aggressive biological behavior. The study focused on the long-term outcomes of follicular thyroid carcinoma and features predictive of adverse outcomes. After reviewing the histology, 22 patients with follicular thyroid carcinoma and these patients were treated during the study period. The median period of follow-up was 132 months. Disease-free survival (DFS) at the end of the study period was 59%, and adverse outcomes were recorded at 36%. Evident or obscure distant metastasis at the time of diagnosis was the strong predictor of adverse outcomes, which included disease-specific mortality. The most typical site of distant metastases was the lungs. The osseous metastases did not respond fully, even when iodine avidity was retained. Follicular thyroid carcinoma is an aggressive subtype of differentiated thyroid carcinoma (DTC) and requires aggressive management.

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  1. Kilfoy BA, Zheng T, Holford TR, et al. International patterns and trends in thyroid cancer incidence, 1973-2002. Cancer Causes Control 2009;20(5):525–531. DOI: 10.1007/s10552-008-9260-4
  2. Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA 2006;295(18):2164–2167. DOI: 10.1001/jama.295.18.2164
  3. LiVolsi VA, Asa SL. The demise of follicular carcinoma of the thyroid gland. Thyroid 1994;4(2):233–236. DOI: 10.1089/thy.1994.4.233
  4. Alfalah H, Cranshaw I, Jany T, et al. Risk factors for lateral cervical lymph node involvement in follicular thyroid carcinoma. World J Surg 2008;32(12):2623–2626. DOI: 10.1007/s00268-008-9742-2
  5. Parameswaran R, Shulin Hu J, Min En N, et al. Patterns of metastasis in follicular thyroid carcinoma and the difference between early and delayed presentation. Ann R Coll Surg Engl 2017;99(2):151–154. DOI: 10.1308/rcsann.2016.0300
  6. Mete O, Asa SL. Pathological definition and clinical significance of vascular invasion in thyroid carcinomas of follicular epithelial derivation. Mod Pathol 2011;24(12):1545–1552. DOI: 10.1038/modpathol.2011.119
  7. Sobrinho Simões M, Asa SL, Kroll TG, et al. WHO Classification of Tumors. Pathology and Genetics. Tumours of Endocrine: Organs. Lyon, France: IARC Press; 2004. pp. 67–76.
  8. Ito Y, Hirokawa M, Masuoka H, et al. Prognostic factors of minimally invasive follicular thyroid carcinoma: extensive vascular invasion significantly affects patient prognosis. Endocr J 2013;60(5):637–642. DOI: 10.1507/endocrj.ej12-0419
  9. WHO Classification of Tumours Editorial Board. Lyon: International Agency for Research on Cancer; 2022. Endocrine and neuroendocrine tumours.
  10. Zhao H, Liu C-H, Cao Y, et al. Survival prognostic factors for differentiated thyroid cancer patients with pulmonary metastases: a systematic review and meta-analysis. Front Oncol 2022;12:990154. DOI: 10.3389/fonc.2022.990154
  11. Ruegemer JJ, Hay ID, Bergstralh EJ, et al. Distant metastases in differentiated thyroid carcinoma: a multivariate analysis of prognostic variables. J Clin Endocrinol Metab 1988;67(3):501–508. DOI: 10.1210/jcem-67-3-501
  12. Guidelines of the Papanicolaou society of cytopathology for the examination of fine-needle aspiration specimens from thyroid nodules. The Papanicolaou society of cytopathology task force on standards of practice. Diagn Cytopathol 1996;15(1):84–89. DOI: 10.1002/(SICI)1097-0339(199607)15:1<84::AID-DC18>3.0.CO;2-8
  13. Cooper DS, Doherty GM, Haugen BR, et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer: Thyroid 2006;16(2):109–142. DOI: 10.1089/thy.2006.16.109
  14. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016;26(1):1–133. DOI: 10.1089/thy.2015.0020
  15. Gupta S, Ajise O, Dultz L, et al. Follicular variant of papillary thyroid cancer: encapsulated, nonencapsulated, and diffuse: distinct biologic and clinical entities. Arch Otolaryngol Head Neck Surg 2012;138(3):227–233. DOI: 10.1001/archoto.2011.1466
  16. Pisanu A, Deplano D, Pili M, et al. Larger tumour size predicts nodal involvement in patients with follicular thyroid carcinoma. Tumori 2011;97(3):296–303. DOI: 10.1177/030089161109700307
  17. Shaha AR, Shah JP, Loree TR. Differentiated thyroid cancer presents initially with distant metastasis. Am J Surg 1997;174(5):474–476. DOI: 10.1016/s0002-9610(97)00158-x
  18. Sabra MM, Ghossein R, Tuttle RM. Time course and predictors of structural disease progression in pulmonary metastases arising from follicular cell-derived thyroid cancer. Thyroid 2016;26(4):518–524. DOI: 10.1089/thy.2015.0395
  19. Wu MH, Lee YY, Lu YL, et al. Risk factors and prognosis for metastatic follicular thyroid cancer. Front Endocrinol (Lausanne) 2022;13:791826. DOI: 10.3389/fendo.2022.791826
  20. O’Neill CJ, Vaughan L, Learoyd DL, et al. Management of follicular thyroid carcinoma should be individualised based on degree of capsular and vascular invasion. Eur J Surg Oncol 2011;37(2):181–185. DOI: 10.1016/j.ejso.2010.11.005
  21. Nagahama M, Kitagawa W, Shibuya H, et al. Prognosis and prognostic factors for distant metastases and tumor mortality in follicular thyroid carcinoma. Thyroid 2011;21(7):751–757. DOI: 10.1089/thy.2010.0353
  22. Cipriani NA, Nagar S, Kaplan SP, et al. Follicular thyroid carcinoma: how have histologic diagnoses changed in the last half-century and what are the prognostic implications? Thyroid 2015;25(11):1209–1216. DOI: 10.1089/thy.2015.0297
  23. Sturniolo G, Violi MA, Galletti B, et al. Differentiated thyroid carcinoma in lingual thyroid. Endocrine 2016;51(1):189–98. DOI: 10.1007/s12020-015-0593-y
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