[Poorly differentiated thyroid follicular carcinoma - a clinical analysis of 30 cases].
OBJECTIVE
Poorly differentiated thyroid follicular carcinoma is rare, and there were few reports on it. This study was designed to determine clinical characteristics, treatment, and prognosis of poorly differentiated thyroid follicular carcinoma.


METHODS
Thirty patients with poorly differentiated thyroid follicular carcinoma were investigated retrospectively for their general clinical manifestation, process of treatment,and prognosis. Duration of survival from operation to various endpoints, including local recurrence, distant metastasis, and death from cancer or any causes, was estimated by Kaplan-Meier method. Factors that might be related to prognosis, including age, gender, tumor size, extrathyroidal extension, treatment, and operation status, were analyzed by log-rank test. The difference of data between 2 groups was estimated by t test.


RESULTS
The 3-, 5-, 10-year overall survival rates of 30 patients with poorly differentiated thyroid follicular carcinoma were 32.2%, 25.1%, and 12.5%, respectively. The cumulative recurrence rate, regional lymph node metastasis rate, and distant metastasis rate were 37.6%, 57.6%, and 82.5% at 3 years, and 48.0%, 68.2%, and 86.9% at 5 years, respectively. The local recurrence rate decreased significantly (Chi(2)=6.59,P=0.01), and the survival rate increased significantly (Chi(2)=12.40,P=0.00) for patients who had complete removal of the primary lesion and neck metastasis. The recurrence rate of patients with venous tumorous emboli was remarkably higher than that of other patients,(Chi(2)=4.62,P=0.03). The survival time of patients with distant metastases, who had undergone 131I therapy, was significantly longer than that of other patients, who had not undergone 131I therapy (Chi(2)=12.25,P=0.00).


CONCLUSIONS
Patients with poorly differentiated thyroid follicular carcinoma had high distant metastasis rate, and poor prognosis. Distant metastasis is an important factor that affects the survival rate. Radical resection is important for control primary tumor, and improve survival rate. 131I therapy is an effective treatment and could prolong the survival time of patients with distant metastases.
Liu
Wen-Sheng
WS
Department of Head and Neck Surgery, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100021, PR China. Lwsdoctor@yahoo.com.cn
Qi
Yong-Fa
YF
Tang
Ping-Zhang
PZ
D018263:Adenocarcinoma, Follicular / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D013965:Thyroidectomy