J Endocr Surg.  2018 Sep;18(3):183-190. 10.16956/jes.2018.18.3.183.

Long Term Outcome of Minimally Invasive Follicular Thyroid Carcinoma according to Risk Group Stratification

• Lee YM
• Sung TY
• Yoon JH
• Chung KW
• Hong SJ

• KMID: 2420775
• DOI: http://doi.org/10.16956/jes.2018.18.3.183

Abstract

PURPOSE
This study evaluated the risk factors for distant metastasis in patients with minimally invasive follicular thyroid carcinoma (MIFTC) and compared distant metastasis-free survival (DMFS) rates between the groups divided based on the number of involved risk factors.
METHODS
Patients were divided into 4 groups based on the number of involved risk factors; group 0 with no risk factor, group 1 with any one risk factor, group 2 with any 2 risk factors, and group 3 with all risk factors.
RESULTS
The 195 patients were enrolled in this study. Distant metastasis was detected in 15 patients (7.7%). In the multivariate analysis, age ≥ 45 years (hazard ratio [HR]=5.95; 95% confidence interval [CI]=1.44-24.55; P=0.014), primary tumor size >4.0 cm (HR=4.79; 95% CI=1.18-19.33; P=0.028), and extensive vascular invasion with ≥4 foci (HR=19.63; 95% CI=5.18-74.39; P < 0.001) were identified as independent risk factors for distant metastasis. Group 1 tended to have poorer DMFS rates as compared with group 0, but there was no significant difference (P=0.069). DMFS rates of group 2 and 3 were significantly poorer than those of group 1 (P < 0.001 and < 0.001, respectively). DMFS rates of group 3 were also significantly poorer than those of group 2 (P=0.004).
CONCLUSION
MIFTC patients with no or only one distant metastasis-related risk factor may become candidates for close observation without additional treatments with respect to DMFS rates.

Keyword

Follicular thyroid carcinoma; Risk assessment; Prognosis

MeSH Terms

Adenocarcinoma, Follicular*
Humans
Multivariate Analysis
Neoplasm Metastasis
Prognosis
Risk Assessment
Risk Factors

Figure

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  Fig. 1 Relative risk for distant metastasis according to the number and composition of involved risk factors.

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  Fig. 2 Distant metastasis-free survival rates based on the number of involved risk factors and risk group stratification.

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