ECE2022 Poster Presentations Late-Breaking (41 abstracts)
1National and Kapodistrian University of Athens, 2 nd Department of Surgery, Aretaieion Hospital, Athens, Greece; 2424 General Military Hospital, Department of Endocrinology, Thessaloniki, Greece; 3National and Kapodistrian University of Athens, Department of Pathology, Athens, Greece; 4Henry Dunant Hospital Center, Department of Endocrine Surgery, Athens, Greece
Background: Although papillary thyroid carcinoma (PTC) is considered to have an excellent prognosis, some more aggressive variants have been identified that show reduced overall survival rates. Besides from the diffuse sclerosing, tall cell, columnar cell, and solid variant, the hobnail variant was newly recognized as one of these aggressive forms, affecting recurrence, metastasis, and overall survival rates.
Methods: We performed a systematic review and meta-analysis of studies including cases or case series with patients with hobnail variant of PTC. Furthermore, we included our own case series consisting of six patients.
Results: The pooled mortality rate in the cohort consisting of 191 patients was 3.43 (95% CI 1.72-6.82) per 1000 person/months. No sex differences could be observed concerning mortality (P=0.52) but older age and tumor size significantly affected mortality (P=0.03 andP=0.02, respectively). The percentage of hobnail variant did not affect mortality (P=0.29), neither did the presence of BRAF mutations. Classical characteristics as the presence of extrathyroidal extension (P=0.001), distant metastases (P<0.001) and lymph node metastases (P<0.001) all had a significant impact on mortality.
Conclusions: Hobnail variant correlates with worse overall survival and all PTC cases should be carefully assessed for this variant.