title: Prognostic indications for Hürthle cell cancer.
abstract: Hürthle cell carcinoma (HCC) has been reported to have variable clinical behavior. The objective of this study was to determine the important prognostic factors in patients with HCC. It was a retrospective investigation of 33 patients with HCC treated in our institution from 1976 to 2002. The average age of our 33 patients with HCC was 55.2 years (range 20-82 years; 23 women, 10 men). Fifteen patients (45.5%) presented with a T2 tumor, 7 (21.2%) with a T3 tumor, and 8 (24.2%) with a T4 tumor; the tumor stage was unknown in three patients. Coexisting papillary carcinoma occurred in six patients (18%), 9% of whom presented with metastatic disease. Twelve patients (36.4%) had metastases, four of whom (12.2%) had persistent HCC, and 8 (24.2%) developed recurrent HCC (range 1-9 years). Eight of these twelve patients (66.7%) died from the HCC. The average follow-up time was 5.5 years (range 1-16 years). Altogether, 3 of 23 women and 5 of 10 men died from their HCC ( p < 0.05). Of the 22 patients with T2-T3 tumors, 5 (22.7%) developed metastases and 1 patient died; 5 of 8 patients (62.5%) with T4 tumors developed metastases and died ( p < 0.01). Patients who were treated by less than total thyroidectomy had a worse prognosis by univariate analysis ( p < 0.01) but not by multivariate analysis. Survival time for patients with persistent disease was shorter than for those with recurrent disease ( p < 0.05). Multivariate analysis, however, revealed no difference for extent of operation or those with persistent and recurrent disease. The cause-specific survivals were 74% and 49% at 5 and 10 years, respectively. Disease-free survivals were 65.0% and 40.5% at 5 and 10 years, respectively. Our findings show that gender and stage of disease influence the prognosis of patients with HCC.
authors.affiliation: Endocrine Surgical Oncology, Department of Surgery, University of California-San Francisco/Mount Zion Medical Center, 1600 Divisadero Street, San Francisco, CA 94143-1674, USA.
authors.forename: Yevgeniya
authors.initials: Y
authors.lastname: Kushchayeva
authors.forename: Quan-Yang
authors.initials: QY
authors.lastname: Duh
authors.forename: Electron
authors.initials: E
authors.lastname: Kebebew
authors.forename: Orlo H
authors.initials: OH
authors.lastname: Clark
mesh_terms: D018249:Adenoma, Oxyphilic / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy