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Vascular invasion is an independent prognostic factor for distant recurrence-free survival in papillary thyroid carcinoma: a matched-case comparative study
  1. Jun Cao1,
  2. Jin-Lin Hu2,
  3. Can Chen3,
  4. Qing-Liang Wang4,
  5. Xian-Hua Fang2,
  6. Yan Zhang1,
  7. Ming-Hua Ge1
  1. 1Department of Head and Neck Surgery, Zhejiang Cancer Hospital, Hangzhou, China
  2. 2Department of Pathology, Zhejiang Cancer Hospital, Hangzhou, China
  3. 3Department of Hematology, The First Affiliated Hangzhou People's Hospital of Zhejiang Chinese Medical University, Hangzhou, China
  4. 4Department of Otorhinolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
  1. Correspondence to Dr Ming-Hua Ge, Department of Head and Neck Surgery, Zhejiang Cancer Hospital, 38 Guangji Road, Gongshu District, Hangzhou 310022, China; gemingh{at}163.com

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.

Design 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.

  • THYROID
  • THYROID CANCER
  • THYROID ENDOCRINOLOGY

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