title: Clinical features and outcome of the tall cell variant of papillary thyroid carcinoma.
abstract: OBJECTIVE
  To study the clinical features and outcome of the tall cell variant (TCV) of papillary thyroid carcinoma (PTC).
  
  
  METHODS
  A single-institution retrospective analysis was performed to review patients with TCV and the usual type of PTC diagnosed from 1960 to 2000.
  
  
  RESULTS
  Fourteen of 1,108 patients (median follow-up, 8.9 yr) diagnosed with PTC had TCV. Ten were female, and four were male, with a mean age of 53.7 (33-81) years. All were ethnic Chinese. Compared with the usual PTC cohort, TCV patients presented at an older age (mean, 53.7 vs. 45.2 yr; P = .015). They had a higher rate of extrathyroidal extension (78.6% vs. 43.4%, P = .009), tracheal invasion (28.6% vs. 9%, P = .034), and carotid vessel invasion (14.3% vs. 1.5%, P = .021). TCV patients had more frequent gross (42.9% vs. 17.2%) and microscopic (14.3% vs. 6%) postoperative locoregional residual disease (P = .008). They also had a higher percentage of stage III and IV disease (American Joint Committee on Cancer, 6th ed) (74.3% vs. 31.3%, P = .009). Ten-year local failure-free, regional failure-free, and metastasis-free survival were worse in the TCV group (78.6% vs. 88.8%. P = .017; 53.0% vs. 85.9%, P < .0001; 35.7% vs. 92.1%, P < .0001, respectively). The 10-year cause-specific survival was also lower in TCV patients (48.2% vs. 93.4%, P < .0001).
  
  
  CONCLUSIONS
  TCV presents at a higher stage with more advanced local disease. It has a higher risk of locoregional and distant relapse and a worse overall survival rate. Stratification by stage reveals that TCV has significantly higher mortality compared with PTC for stage IV disease. Aggressive treatment and close follow-up of these patients is necessary.
authors.affiliation: Department of Clinical Oncology, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong, People's Republic of China. alexkcleung@gmail.com
authors.forename: Alex Kwok-Cheung
authors.initials: AK
authors.lastname: Leung
authors.forename: Sin-Ming
authors.initials: SM
authors.lastname: Chow
authors.forename: Stephen C K
authors.initials: SC
authors.lastname: Law
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000208:ethnology / Q000473:pathology* / Q000601:surgery; D002339:Carotid Arteries / Q000473:pathology; D002681:China / Q000208:ethnology; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D012189:Retrospective Studies; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000208:ethnology / Q000473:pathology* / Q000601:surgery; D014134:Tracheal Neoplasms / Q000473:pathology; D016896:Treatment Outcome