title: Prognostic factors of minimally invasive follicular thyroid carcinoma: extensive vascular invasion significantly affects patient prognosis.
abstract: Follicular thyroid carcinoma (FTC) is divided into two categories: minimally and widely invasive FTC. Generally, the prognosis of minimally invasive FTC is excellent, but patients showing certain characteristics have a dire prognosis. In this study, we investigated the prognostic factors of minimally invasive FTC using a series of 292 patients. On multivariate analysis, extensive (4 or more) vascular invasion, age ≥ 45 years, and tumor size > 4 cm were independent prognostic factors of patient disease-free survival (DFS). Distant metastasis at diagnosis (M1) was the strongest prognostic factor of cause-specific survival (CSS). Extensive vascular invasion and tumor size > 4 cm also independently affected patient carcinoma death. Capsular invasion was not related to patient prognosis. The ten-year DFS rate of patients with extensive vascular invasion was 80%, which was poorer than that of those having tumor size > 4 cm (91%) and aged 45 years or older (90%). These findings suggest that 1) M1 most strongly affects the CSS of patients, and 2) M0 patients with extensive vascular invasion may be candidates for completion total thyroidectomy and radioactive iodine ablation.
authors: Department of Surgery, Kuma Hospital, Kobe 650-0011, Japan. ito01@kuma-h.or.jp
authors: Yasuhiro
authors: Y
authors: Ito
authors: Mitsuyoshi
authors: M
authors: Hirokawa
authors: Hiroo
authors: H
authors: Masuoka
authors: Tomonori
authors: T
authors: Yabuta
authors: Minoru
authors: M
authors: Kihara
authors: Takuya
authors: T
authors: Higashiyama
authors: Yuuki
authors: Y
authors: Takamura
authors: Kaoru
authors: K
authors: Kobayashi
authors: Akihiro
authors: A
authors: Miya
authors: Akira
authors: A
authors: Miyauchi
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D007564:Japan / Q000453:epidemiology; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D009389:Neovascularization, Pathologic / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D016019:Survival Analysis; D013961:Thyroid Gland / Q000098:blood supply / Q000473:pathology* / Q000528:radiation effects / Q000601:surgery; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals