title: Association of vascular invasion with increased mortality in patients with minimally invasive follicular thyroid carcinoma but not widely invasive follicular thyroid carcinoma.
abstract: BACKGROUND
  The association of vascular invasion with tumor aggressiveness and poor prognosis in follicular thyroid carcinoma (FTC) remains controversial.
  
  
  METHODS
  We reviewed medical records of 204 patients with histologically confirmed FTC.
  
  
  RESULTS
  The disease-specific survival rates at 5 and 10 years were 94% and 85%, respectively. Using Cox proportional hazard model, the extent of invasiveness and the frequency of distant metastasis were found to be independent prognostic factors for survival in all patients with FTC. When we performed individual analyses stratified by the extent of invasiveness, vascular invasion was an independent predictor of disease-specific survival in minimally invasive FTC, but that did not independently affect survival in widely invasive FTC.
  
  
  CONCLUSIONS
  This study suggests that vascular invasion is associated with aggressive features of FTC and independently influences outcomes in minimally invasive FTC. For patients aged <45 years with minimally invasive FTC without vascular invasion, thyroid lobectomy alone may be adequate.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hye Jeong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Ji-Youn
authors.initials: JY
authors.lastname: Sung
authors.forename: Young Lyun
authors.initials: YL
authors.lastname: Oh
authors.forename: Jung Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Young-Ik
authors.initials: YI
authors.lastname: Son
authors.forename: Yong-Ki
authors.initials: YK
authors.lastname: Min
authors.forename: Sun Wook
authors.initials: SW
authors.lastname: Kim
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Chung
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome; D055815:Young Adult
keywords: follicular; prognosis; survival; thyroid cancer; vascular invasion