title: Vascular invasion is an independent prognostic factor for distant recurrence-free survival in papillary thyroid carcinoma: a matched-case comparative study.
abstract: OBJECTIVE
  It is still unclear whether the clinicopathological and outcome characteristics of vascular invasion (VI) (+) papillary thyroid carcinoma (PTC) differ from VI (-) PTC. This study aims to establish distinguishing features of patients with VI (+) and VI (-) PTC and to investigate the biological and clinical aggressiveness of the disease in these patient groups.
  
  
  METHODS
  A matched-case comparative study.
  
  
  METHODS
  412 patients (VI (+) PTC study group n=103, and VI (-) PTC control group n=309). These two patient groups were matched 1:3 for variables of age, gender, histological variants, tumour/node/metastasis (TNM) staging and approximate duration of follow-up. Clinicopathological factors and prognosis were compared across the two patient groups.
  
  
  RESULTS
  The median age at the time of diagnosis was 42.0 years, and 68.9% were females. Across the patient groups, the incidence of tumour multifocality in patients with VI (+) PTC was slightly higher than in those with VI (-) PTC (p=0.049). In addition, when undergoing more aggressive therapy regimens patients with VI (+) PTC showed decreased distant recurrence-free survival (DRFS), but not regional recurrence-free survival (RRFS) and disease-specific survival (DSS) compared with patients who were VI (-). VI was found to be an independent predictor of DRFS, combined with tumour size >3 cm and total thyroidectomy.
  
  
  CONCLUSIONS
  VI was an independent risk factor for DRFS, necessitating the need for appropriate postoperative treatment and careful follow-up.
authors.affiliation: Department of Head and Neck Surgery, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Cao
authors.affiliation: Department of Pathology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Jin-Lin
authors.initials: JL
authors.lastname: Hu
authors.affiliation: Department of Hematology, The First Affiliated Hangzhou People's Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
authors.forename: Can
authors.initials: C
authors.lastname: Chen
authors.affiliation: Department of Otorhinolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China.
authors.forename: Qing-Liang
authors.initials: QL
authors.lastname: Wang
authors.affiliation: Department of Pathology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Xian-Hua
authors.initials: XH
authors.lastname: Fang
authors.affiliation: Department of Head and Neck Surgery, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Head and Neck Surgery, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Ming-Hua
authors.initials: MH
authors.lastname: Ge
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000098:blood supply / Q000401:mortality / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000098:blood supply / Q000401:mortality / Q000473:pathology*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D042601:Lymphatic Vessels / Q000473:pathology; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000098:blood supply / Q000401:mortality / Q000473:pathology*; D013965:Thyroidectomy; D055815:Young Adult
keywords: THYROID; THYROID CANCER; THYROID ENDOCRINOLOGY