title: Multivariate analysis of clinicopathologic parameters for the insular subtype of differentiated thyroid carcinoma.
abstract: OBJECTIVE
  Insular carcinoma represents a more aggressive subtype of differentiated thyroid cancer on multivariate analysis after controlling for various clinicopathologic parameters.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Tertiary referral center at a university hospital.
  
  
  METHODS
  One hundred twenty-seven consecutive patients having a histological diagnosis of the follicular variant of papillary thyroid carcinoma or follicular thyroid carcinoma.
  
  
  METHODS
  A logistic regression model was used to examine the relationship between various clinicopathologic parameters and the insular subtype.
  
  
  RESULTS
  The insular subtype involved 14 of 127 tumors. Unlike extrathyroidal extension and nodal metastasis, primary tumor diameter (> 40 mm vs < or = 40 mm; P = .008) and distant metastasis (P = .003) correlated with the insular subtype. Both parameters were interrelated since tumors greater than 40 mm displayed distant metastasis more often (30% vs 8%; P = .008) than tumors measuring 40 mm or less.
  
  
  CONCLUSIONS
  These findings suggest that an unidentified somatic event may induce an accelerated proliferation of the transformed thyrocytes, which may ultimately result in enhanced rates of distant metastasis with increasing tumor volume.
authors.affiliation: Department of General Surgery, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, D-06097 Halle/Saale, Germany. gensurg@medizin.uni-halle.de
authors.forename: A
authors.initials: A
authors.lastname: Machens
authors.forename: R
authors.initials: R
authors.lastname: Hinze
authors.forename: C
authors.initials: C
authors.lastname: Lautenschläger
authors.forename: H
authors.initials: H
authors.lastname: Dralle
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000235:genetics / Q000473:pathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009154:Mutation; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000235:genetics / Q000473:pathology*