Differential clinicopathological risk and prognosis of major papillary thyroid cancer variants

Xiaoguang Shi, Rengyun Liu, Fulvio Basolo, Riccardo Giannini, Xiaopei Shen, Di Teng, Haixia Guan, Zhongyan Shan, Weiping Teng, Thomas J. Musholt, Khawla Al-Kuraya, Laura Fugazzola, Carla Colombo, Electron Kebebew, Barbara Jarzab, Agnieszka Czarniecka, Bela Bendlova, Vlasta Sykorova, Manuel Sobrinho-Simães, Paula Soares & 28 others Young Kee Shong, Tae Yong Kim, Sonia Cheng, Sylvia L. Asa, David Viola, Rossella Elisei, Linwah Yip, Caterina Mian, Federica Vianello, Yangang Wang, Shihua Zhao, Gisele Oler, Janete M. Cerutti, Efisio Puxeddu, Shen Qu, Qing Wei, Huixiong Xu, Christine J. O'Neill, Mark S. Sywak, Roderick Clifton-Bligh, Alfred K. Lam, Garcilaso Riesco-Eizaguirre, Pilar Santisteban, Hongyu Yu, Giovanni Tallini, Elizabeth H. Holt, Vasily Vasko, Michael Mingzhao Xing

Research output: Contribution to journalArticle

Abstract

Context: Individualized management, incorporating papillary thyroid cancer (PTC) variant-specific risk, is conceivably a useful treatment strategy for PTC, which awaits comprehensive data demonstrating differential risks of PTC variants to support. Objective: This study sought to establish the differential clinicopathological risk of major PTC variants: conventional PTC (CPTC), follicular-variant PTC (FVPTC), and tall-cell PTC (TCPTC). Methods: Thiswasa retrospective study of clinicopathological outcomes of 6282 PTC patients (4799 females and 1483 males) from 26 centers and The Cancer Genome Atlas in 14 countries with a median age of 44 years (interquartile range, 33â€"56 y) and median follow-up time of 37 months (interquartile range, 15â€"82 mo). Results: The cohort consisted of 4702 (74.8%) patients with CPTC, 1126 (17.9%) with FVPTC, and 239 (3.8%) with TCPTC. The prevalence of high-risk parameters was significantly different among the three variants, including extrathyroidal invasion, lymph node metastasis, stages III/IV, disease recurrence, mortality, and the use (need) of radioiodine treatment (all P > .001), being highest in TCPTC, lowest in FVPTC, and intermediate in CPTC, following an order of TCPTC>CPTC蠑FVPTC. Recurrence and mortality in TCPTC, CPTC, and FVPTC were 27.3 and 6.7%, 16.1 and 2.5%, and 9.1 and 0.6%, corresponding to events per 1000 person-years (95% confidence interval [CI]) of 92.47 (64.66â€"132.26) and 24.61 (12.31â€" 49.21), 34.46 (30.71â€"38.66), and 5.87 (4.37â€"7.88), and 24.73 (18.34 â€"33.35) and 1.68 (0.54 â€"5.21), respectively. Mortality hazard ratios of CPTC and TCPTC over FVPTC were 3.44 (95% CI, 1.07â€"11.11) and 14.96 (95% CI, 3.93â€"56.89), respectively. Kaplan-Meier survival analyses showed the best prognosis in FVPTC, worst in TCPTC, and intermediate in CPTC in disease recurrence-free probability and disease-specific patient survival. This was particularly the case in patients at least 45 years old. Conclusion: This large multicenter study demonstrates differential prognostic risks of the three major PTC variants and establishes a unique risk order of TCPTC > CPTC 蠑 FVPTC, providing important clinical implications for specific variant-based management of PTC.

Original languageEnglish (US)
Pages (from-to)264-274
Number of pages11
JournalJournal of Clinical Endocrinology and Metabolism
Volume101
Issue number1
DOIs
StatePublished - Jan 1 2016

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Factor IX
Papillary Thyroid cancer
Confidence Intervals
Recurrence
Mortality

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

Differential clinicopathological risk and prognosis of major papillary thyroid cancer variants. / Shi, Xiaoguang; Liu, Rengyun; Basolo, Fulvio; Giannini, Riccardo; Shen, Xiaopei; Teng, Di; Guan, Haixia; Shan, Zhongyan; Teng, Weiping; Musholt, Thomas J.; Al-Kuraya, Khawla; Fugazzola, Laura; Colombo, Carla; Kebebew, Electron; Jarzab, Barbara; Czarniecka, Agnieszka; Bendlova, Bela; Sykorova, Vlasta; Sobrinho-Simães, Manuel; Soares, Paula; Shong, Young Kee; Kim, Tae Yong; Cheng, Sonia; Asa, Sylvia L.; Viola, David; Elisei, Rossella; Yip, Linwah; Mian, Caterina; Vianello, Federica; Wang, Yangang; Zhao, Shihua; Oler, Gisele; Cerutti, Janete M.; Puxeddu, Efisio; Qu, Shen; Wei, Qing; Xu, Huixiong; O'Neill, Christine J.; Sywak, Mark S.; Clifton-Bligh, Roderick; Lam, Alfred K.; Riesco-Eizaguirre, Garcilaso; Santisteban, Pilar; Yu, Hongyu; Tallini, Giovanni; Holt, Elizabeth H.; Vasko, Vasily; Xing, Michael Mingzhao.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 101, No. 1, 01.01.2016, p. 264-274.

Research output: Contribution to journalArticle

Shi, X, Liu, R, Basolo, F, Giannini, R, Shen, X, Teng, D, Guan, H, Shan, Z, Teng, W, Musholt, TJ, Al-Kuraya, K, Fugazzola, L, Colombo, C, Kebebew, E, Jarzab, B, Czarniecka, A, Bendlova, B, Sykorova, V, Sobrinho-Simães, M, Soares, P, Shong, YK, Kim, TY, Cheng, S, Asa, SL, Viola, D, Elisei, R, Yip, L, Mian, C, Vianello, F, Wang, Y, Zhao, S, Oler, G, Cerutti, JM, Puxeddu, E, Qu, S, Wei, Q, Xu, H, O'Neill, CJ, Sywak, MS, Clifton-Bligh, R, Lam, AK, Riesco-Eizaguirre, G, Santisteban, P, Yu, H, Tallini, G, Holt, EH, Vasko, V & Xing, MM 2016, 'Differential clinicopathological risk and prognosis of major papillary thyroid cancer variants', Journal of Clinical Endocrinology and Metabolism, vol. 101, no. 1, pp. 264-274. https://doi.org/10.1210/jc.2015-3095
Shi, Xiaoguang ; Liu, Rengyun ; Basolo, Fulvio ; Giannini, Riccardo ; Shen, Xiaopei ; Teng, Di ; Guan, Haixia ; Shan, Zhongyan ; Teng, Weiping ; Musholt, Thomas J. ; Al-Kuraya, Khawla ; Fugazzola, Laura ; Colombo, Carla ; Kebebew, Electron ; Jarzab, Barbara ; Czarniecka, Agnieszka ; Bendlova, Bela ; Sykorova, Vlasta ; Sobrinho-Simães, Manuel ; Soares, Paula ; Shong, Young Kee ; Kim, Tae Yong ; Cheng, Sonia ; Asa, Sylvia L. ; Viola, David ; Elisei, Rossella ; Yip, Linwah ; Mian, Caterina ; Vianello, Federica ; Wang, Yangang ; Zhao, Shihua ; Oler, Gisele ; Cerutti, Janete M. ; Puxeddu, Efisio ; Qu, Shen ; Wei, Qing ; Xu, Huixiong ; O'Neill, Christine J. ; Sywak, Mark S. ; Clifton-Bligh, Roderick ; Lam, Alfred K. ; Riesco-Eizaguirre, Garcilaso ; Santisteban, Pilar ; Yu, Hongyu ; Tallini, Giovanni ; Holt, Elizabeth H. ; Vasko, Vasily ; Xing, Michael Mingzhao. / Differential clinicopathological risk and prognosis of major papillary thyroid cancer variants. In: Journal of Clinical Endocrinology and Metabolism. 2016 ; Vol. 101, No. 1. pp. 264-274.
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title = "Differential clinicopathological risk and prognosis of major papillary thyroid cancer variants",
abstract = "Context: Individualized management, incorporating papillary thyroid cancer (PTC) variant-specific risk, is conceivably a useful treatment strategy for PTC, which awaits comprehensive data demonstrating differential risks of PTC variants to support. Objective: This study sought to establish the differential clinicopathological risk of major PTC variants: conventional PTC (CPTC), follicular-variant PTC (FVPTC), and tall-cell PTC (TCPTC). Methods: Thiswasa retrospective study of clinicopathological outcomes of 6282 PTC patients (4799 females and 1483 males) from 26 centers and The Cancer Genome Atlas in 14 countries with a median age of 44 years (interquartile range, 33{\^a}€{"}56 y) and median follow-up time of 37 months (interquartile range, 15{\^a}€{"}82 mo). Results: The cohort consisted of 4702 (74.8{\%}) patients with CPTC, 1126 (17.9{\%}) with FVPTC, and 239 (3.8{\%}) with TCPTC. The prevalence of high-risk parameters was significantly different among the three variants, including extrathyroidal invasion, lymph node metastasis, stages III/IV, disease recurrence, mortality, and the use (need) of radioiodine treatment (all P > .001), being highest in TCPTC, lowest in FVPTC, and intermediate in CPTC, following an order of TCPTC>CPTC蠑FVPTC. Recurrence and mortality in TCPTC, CPTC, and FVPTC were 27.3 and 6.7{\%}, 16.1 and 2.5{\%}, and 9.1 and 0.6{\%}, corresponding to events per 1000 person-years (95{\%} confidence interval [CI]) of 92.47 (64.66{\^a}€{"}132.26) and 24.61 (12.31{\^a}€{"} 49.21), 34.46 (30.71{\^a}€{"}38.66), and 5.87 (4.37{\^a}€{"}7.88), and 24.73 (18.34 {\^a}€{"}33.35) and 1.68 (0.54 {\^a}€{"}5.21), respectively. Mortality hazard ratios of CPTC and TCPTC over FVPTC were 3.44 (95{\%} CI, 1.07{\^a}€{"}11.11) and 14.96 (95{\%} CI, 3.93{\^a}€{"}56.89), respectively. Kaplan-Meier survival analyses showed the best prognosis in FVPTC, worst in TCPTC, and intermediate in CPTC in disease recurrence-free probability and disease-specific patient survival. This was particularly the case in patients at least 45 years old. Conclusion: This large multicenter study demonstrates differential prognostic risks of the three major PTC variants and establishes a unique risk order of TCPTC > CPTC 蠑 FVPTC, providing important clinical implications for specific variant-based management of PTC.",
author = "Xiaoguang Shi and Rengyun Liu and Fulvio Basolo and Riccardo Giannini and Xiaopei Shen and Di Teng and Haixia Guan and Zhongyan Shan and Weiping Teng and Musholt, {Thomas J.} and Khawla Al-Kuraya and Laura Fugazzola and Carla Colombo and Electron Kebebew and Barbara Jarzab and Agnieszka Czarniecka and Bela Bendlova and Vlasta Sykorova and Manuel Sobrinho-Sim{\~a}es and Paula Soares and Shong, {Young Kee} and Kim, {Tae Yong} and Sonia Cheng and Asa, {Sylvia L.} and David Viola and Rossella Elisei and Linwah Yip and Caterina Mian and Federica Vianello and Yangang Wang and Shihua Zhao and Gisele Oler and Cerutti, {Janete M.} and Efisio Puxeddu and Shen Qu and Qing Wei and Huixiong Xu and O'Neill, {Christine J.} and Sywak, {Mark S.} and Roderick Clifton-Bligh and Lam, {Alfred K.} and Garcilaso Riesco-Eizaguirre and Pilar Santisteban and Hongyu Yu and Giovanni Tallini and Holt, {Elizabeth H.} and Vasily Vasko and Xing, {Michael Mingzhao}",
year = "2016",
month = "1",
day = "1",
doi = "10.1210/jc.2015-3095",
language = "English (US)",
volume = "101",
pages = "264--274",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "The Endocrine Society",
number = "1",

}

TY - JOUR

T1 - Differential clinicopathological risk and prognosis of major papillary thyroid cancer variants

AU - Shi, Xiaoguang

AU - Liu, Rengyun

AU - Basolo, Fulvio

AU - Giannini, Riccardo

AU - Shen, Xiaopei

AU - Teng, Di

AU - Guan, Haixia

AU - Shan, Zhongyan

AU - Teng, Weiping

AU - Musholt, Thomas J.

AU - Al-Kuraya, Khawla

AU - Fugazzola, Laura

AU - Colombo, Carla

AU - Kebebew, Electron

AU - Jarzab, Barbara

AU - Czarniecka, Agnieszka

AU - Bendlova, Bela

AU - Sykorova, Vlasta

AU - Sobrinho-Simães, Manuel

AU - Soares, Paula

AU - Shong, Young Kee

AU - Kim, Tae Yong

AU - Cheng, Sonia

AU - Asa, Sylvia L.

AU - Viola, David

AU - Elisei, Rossella

AU - Yip, Linwah

AU - Mian, Caterina

AU - Vianello, Federica

AU - Wang, Yangang

AU - Zhao, Shihua

AU - Oler, Gisele

AU - Cerutti, Janete M.

AU - Puxeddu, Efisio

AU - Qu, Shen

AU - Wei, Qing

AU - Xu, Huixiong

AU - O'Neill, Christine J.

AU - Sywak, Mark S.

AU - Clifton-Bligh, Roderick

AU - Lam, Alfred K.

AU - Riesco-Eizaguirre, Garcilaso

AU - Santisteban, Pilar

AU - Yu, Hongyu

AU - Tallini, Giovanni

AU - Holt, Elizabeth H.

AU - Vasko, Vasily

AU - Xing, Michael Mingzhao

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Context: Individualized management, incorporating papillary thyroid cancer (PTC) variant-specific risk, is conceivably a useful treatment strategy for PTC, which awaits comprehensive data demonstrating differential risks of PTC variants to support. Objective: This study sought to establish the differential clinicopathological risk of major PTC variants: conventional PTC (CPTC), follicular-variant PTC (FVPTC), and tall-cell PTC (TCPTC). Methods: Thiswasa retrospective study of clinicopathological outcomes of 6282 PTC patients (4799 females and 1483 males) from 26 centers and The Cancer Genome Atlas in 14 countries with a median age of 44 years (interquartile range, 33â€"56 y) and median follow-up time of 37 months (interquartile range, 15â€"82 mo). Results: The cohort consisted of 4702 (74.8%) patients with CPTC, 1126 (17.9%) with FVPTC, and 239 (3.8%) with TCPTC. The prevalence of high-risk parameters was significantly different among the three variants, including extrathyroidal invasion, lymph node metastasis, stages III/IV, disease recurrence, mortality, and the use (need) of radioiodine treatment (all P > .001), being highest in TCPTC, lowest in FVPTC, and intermediate in CPTC, following an order of TCPTC>CPTC蠑FVPTC. Recurrence and mortality in TCPTC, CPTC, and FVPTC were 27.3 and 6.7%, 16.1 and 2.5%, and 9.1 and 0.6%, corresponding to events per 1000 person-years (95% confidence interval [CI]) of 92.47 (64.66â€"132.26) and 24.61 (12.31â€" 49.21), 34.46 (30.71â€"38.66), and 5.87 (4.37â€"7.88), and 24.73 (18.34 â€"33.35) and 1.68 (0.54 â€"5.21), respectively. Mortality hazard ratios of CPTC and TCPTC over FVPTC were 3.44 (95% CI, 1.07â€"11.11) and 14.96 (95% CI, 3.93â€"56.89), respectively. Kaplan-Meier survival analyses showed the best prognosis in FVPTC, worst in TCPTC, and intermediate in CPTC in disease recurrence-free probability and disease-specific patient survival. This was particularly the case in patients at least 45 years old. Conclusion: This large multicenter study demonstrates differential prognostic risks of the three major PTC variants and establishes a unique risk order of TCPTC > CPTC 蠑 FVPTC, providing important clinical implications for specific variant-based management of PTC.

AB - Context: Individualized management, incorporating papillary thyroid cancer (PTC) variant-specific risk, is conceivably a useful treatment strategy for PTC, which awaits comprehensive data demonstrating differential risks of PTC variants to support. Objective: This study sought to establish the differential clinicopathological risk of major PTC variants: conventional PTC (CPTC), follicular-variant PTC (FVPTC), and tall-cell PTC (TCPTC). Methods: Thiswasa retrospective study of clinicopathological outcomes of 6282 PTC patients (4799 females and 1483 males) from 26 centers and The Cancer Genome Atlas in 14 countries with a median age of 44 years (interquartile range, 33â€"56 y) and median follow-up time of 37 months (interquartile range, 15â€"82 mo). Results: The cohort consisted of 4702 (74.8%) patients with CPTC, 1126 (17.9%) with FVPTC, and 239 (3.8%) with TCPTC. The prevalence of high-risk parameters was significantly different among the three variants, including extrathyroidal invasion, lymph node metastasis, stages III/IV, disease recurrence, mortality, and the use (need) of radioiodine treatment (all P > .001), being highest in TCPTC, lowest in FVPTC, and intermediate in CPTC, following an order of TCPTC>CPTC蠑FVPTC. Recurrence and mortality in TCPTC, CPTC, and FVPTC were 27.3 and 6.7%, 16.1 and 2.5%, and 9.1 and 0.6%, corresponding to events per 1000 person-years (95% confidence interval [CI]) of 92.47 (64.66â€"132.26) and 24.61 (12.31â€" 49.21), 34.46 (30.71â€"38.66), and 5.87 (4.37â€"7.88), and 24.73 (18.34 â€"33.35) and 1.68 (0.54 â€"5.21), respectively. Mortality hazard ratios of CPTC and TCPTC over FVPTC were 3.44 (95% CI, 1.07â€"11.11) and 14.96 (95% CI, 3.93â€"56.89), respectively. Kaplan-Meier survival analyses showed the best prognosis in FVPTC, worst in TCPTC, and intermediate in CPTC in disease recurrence-free probability and disease-specific patient survival. This was particularly the case in patients at least 45 years old. Conclusion: This large multicenter study demonstrates differential prognostic risks of the three major PTC variants and establishes a unique risk order of TCPTC > CPTC 蠑 FVPTC, providing important clinical implications for specific variant-based management of PTC.

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