Comparison of prognostic factors between histopathologic types of differentiated thyroid carcinoma

Abstract

Background: there is controversy in regard to the biological characteristics of the different histopathologic types of differentiated thyroid carcinoma.
Objective: to estimate and compare the prognostic factors in patients operated on for papillary, poorly differentiated, follicular and Hürthle cell carcinomas.
Materials and Methods: 994 patients underwent total thyroidectomy between June 2002 and August 2012 for differentiated thyroid carcinoma: 897 papillary carcinomas, 53 with poorly differentiated carcinomas, 27 follicular carcinomas and 17 Hürthle cell carcinomas. Review of clinical records and pathological reports.
Results: patients with papillary carcinoma presented less proportion of older patients, smaller tumor size and major proportion of lymph node metastases; those with poorly differentiated carcinoma showed more proportion of older patients; patients with follicular carcinoma did not presented lymph node metastases, and those with Hürthle cell carcinoma had more proportions of males, less proportion of extracapsular invasion and less lymph node metastases. In relation with papillary carcinoma, patients with Hürthle cell carcinoma had bigger tumor size and less percentage of lymph node metastases. However, in the comparison of two samples of the same size of papillary and Hürthle cell
carcinomas, the only difference were the bigger tumor size of the latter.
Conclusions: histopathologic types of differentiated thyroid carcinomas in the present series showed less difference among the proportion of unfavourable prognostic factors than previously reported. It is possible to speculate that this is due to the present diagnostic anticipation that would allow treating patients with less aggressive therapies.