title: Minimally invasive follicular thyroid carcinomas: prognostic factors.
abstract: Although minimally invasive follicular thyroid carcinoma (MI-FTC) is regarded as an indolent tumour, treatment strategies remain controversial. Our aim was to investigate the outcome for patients with MI-FTC and to identify prognostic parameters to facilitate adequate treatment and follow-up. This retrospective follow-up study involved all cases of MI-FTC operated at the Karolinska University Hospital between 1986 and 2009. Outcome was analysed using death from MI-FTC as endpoint. Fifty-eight patients (41 women and 17 men) with MI-FTC were identified. The median follow-up time was 140 (range 21-308) months. Vascular invasion was observed in 36 cases and was associated with larger tumour size [median 40 (20-76) compared with 24 (10-80) mm for patients with capsular invasion only (P = 0.001)] and older patients [54 (20-92) vs. 44 (11-77) years; P = 0.019]. Patients with vascular invasion were more often treated with thyroidectomy (21/36 compared to 7/22 with capsular invasion only; P = 0.045). Five patients died from metastatic disease of FTC after a median follow-up of 114 (range 41-193) months; all were older than 50 years (51-72) at the time of the initial surgery; vascular invasion was present in all tumours and all but one were treated with thyroidectomy. Univariate analysis identified combined capsular and vascular invasion (P = 0.034), age at surgery ≥50 years (P = 0.023) and male gender (P = 0.005) as related to risk of death from MI-FTC. MI-FTC should not be considered a purely indolent disease. Age at diagnosis and the existence of combined capsular and vascular invasion were identified as important prognostic factors.
authors: Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden.
authors: Gustav
authors: G
authors: Stenson
authors: Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden. inga-lena.nilsson@ki.se.|Department of Breast and Endocrine Surgery, Section of Endocrine and Sarcoma Surgery, Karolinska University Hospital, 171 76, Stockholm, Sweden. inga-lena.nilsson@ki.se.
authors: Inga-Lena
authors: http://orcid.org/0000-0002-8966-3729
authors: IL
authors: Nilsson
authors: Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden.
authors: Ninni
authors: N
authors: Mu
authors: Department of Oncology-Pathology, Karolinska Institutet, CCK, Karolinska University Hospital, 171 76, Stockholm, Sweden.
authors: Catharina
authors: C
authors: Larsson
authors: Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden.|Department of Breast and Endocrine Surgery, Section of Endocrine and Sarcoma Surgery, Karolinska University Hospital, 171 76, Stockholm, Sweden.
authors: Catharina Ihre
authors: CI
authors: Lundgren
authors: Department of Oncology-Pathology, Karolinska Institutet, CCK, Karolinska University Hospital, 171 76, Stockholm, Sweden.
authors: C Christofer
authors: CC
authors: Juhlin
authors: Department of Oncology-Pathology, Karolinska Institutet, CCK, Karolinska University Hospital, 171 76, Stockholm, Sweden.
authors: Anders
authors: A
authors: Höög
authors: Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden.|Sophiahemmet Hospital, 114 86, Stockholm, Sweden.
authors: Jan
authors: J
authors: Zedenius
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000401:mortality / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009389:Neovascularization, Pathologic / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology*; D055815:Young Adult
keywords: Carcinoma; Follicular; Minimally invasive; Prognosis; Thyroid