ECE2022 Poster Presentations Thyroid (136 abstracts)
Clinicopathological characteristics and response to therapy in patients with tall cell variant papillary thyroiid carcinoma in an institution: analysis of 109 cases
Hernan Tala 1 , Josefina Razmilic 1 & Jeannie Slater 2
1Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana/Universidad del Desarrollo, Internal Medicine (Endocrinology Unit), Chile; 2Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana/Universidad del Desarrollo, Pathology Department, Chile
Objectives: 1.-Characterization of patients with tall cell variant papillary thyroid carcinoma (TCV-PTC) at diagnosis (Dx) compared to patients with classic papillary thyroid carcinoma (c-PTC);
2.-Evaluation of response to therapy (RT) in the (TCV-PTC) cohort
Experimental design: Retrospective observational study
Materials and methods: Patients submitted to surgery for PTC in our institution since 2010 were evaluated. Clinicopathological characteristics at dx. were compared between TCV-PTC y c-PTC. Subsequently, the RT in the TCV-PTC cohort was evaluated. Continuous variables (v) are described with median and range and categorical variables as proportions. ANOVA was used to compare continuous variables and chi square or Fisher in categorical variable. Logistic regression was used for multivariate analysis.
Results: From 1475 patients with PTC, 1040 (70%) correspond to c-PTC and 109 (7%) to TCV-PTC. Table 1 compares the clinicopathological characteristics most relevant at Dg. In multivariate analysis, TCV-PTC was independently associated with a higher probability of ETE and LNF-Inv in the pathology report. RAI was given to 86% of patients. Of the 68 patients in whom it was possible to evaluate RT (median follow-up 21 months), 66% presented excellent RT, 16% indeterminate RT and 7% structural incomplete RT. RT was significantly better in patients with tumors ≤2 cm without lymph node metastases (LNM) at Dg (Table2).
| TCV-PTC | c-PTC | p | |
| n=109 | n=1040 | ||
| Age (Median, range) | 46 (19-77) | 42 (6-86) | < 0.05 |
| Female | 83% | 76% | 0.10 |
| Tumoral size ≥10 mm | 43% | 29% | < 0.05 |
| Extra-thyroidal extensión (ETE+) | 47% | 23% | < 0.05 |
| Linfovascular invasión (LNF-Inv) (+) | 46% | 23% | < 0.05 |
| Necrosis (+) | 5% | 1.4% | < 0.05 |
| pT (AJCC 2017) | |||
| pT1a | 55% | 70% | P< 0.05 |
| pT1b | 28% | 21% | |
| pT2 | 5% | 7% | |
| pT3a | 0 | 0.4% | |
| pT3b | 8% | 0.9% | |
| pT4 | 4% | 0.7% | |
| pN0/Nx | 67% | 66% | 0.7 |
| pN1a | 24% | 22% | |
| pN1b | 9% | 12% |
| pT1a/pT1b-N0/Nx | Otros | P | |
| Excelent RT | 31/38 (82%) | 14/30 (46%) | < 0.05 |
| Indeterminate RT | 7/38 (18%) | 9/30 (30%) | |
| Structural incomplete RT | 0 | 7/30 (23%) |
Conclusions: At diagnosis, TCV-PTC has a higher probability of ETE, LNF-Inv, necrosis and larger tumor size. Despite that, RT seems to be good in patients with tumors ≤2 cm without LNM. Studies with longer follow-up and larger number of patients are needed to confirm these observations.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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