Tumour size predicts risk of recurrence in tall cell subtype papillary thyroid carcinoma

David Leong; Connull Leslie; Brodie Laurie; Lachlan Hou; Jo Keyser; Ming Khoon Yew; Simon Ryan; Hieu Nguyen; Dean Lisewski

doi:10.1016/j.amjsurg.2024.03.022

Tumour size predicts risk of recurrence in tall cell subtype papillary thyroid carcinoma

David Leong, Connull Leslie, Brodie Laurie, Lachlan Hou, Jo Keyser, Ming Khoon Yew, Simon Ryan, Hieu Nguyen, Dean Lisewski

Surgery

Research output: Contribution to journal › Review article › peer-review

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Abstract

Background: The tall cell subtype of papillary thyroid cancer (TCPTC) is the most common aggressive subtype and often treated aggressively. This approach may not be necessary in smaller tumours without adverse histological characteristics. Methods: 97 patients with TCPTC defined as a height-to-width ratio of ≥3:1 and at least 30% tall cells were compared against 390 classical papillary thyroid carcinoma (CPTC) based on tumour size with recurrence free survival (RFS) as the primary outcome. Results: TCPTC are more likely to present with adverse histological characteristics. In smaller tumours (<2 cm), only central lymph node metastasis (HR7.16 p = 0.03) and multifocality (HR10.11 p = 0.026) increased recurrence risk. In larger tumours, TCPTC histology (HR3.78 p = 0.002), lymphovascular invasion (HR3.02 p = 0.014) and central lymph node metastasis (HR3.24 p < 0.001) significantly increased recurrence risk. Conclusion: TCPTC tumours <2 cm without central lymph node metastasis and multifocality are similar in risk of recurrence to classical PTC and could be managed with lobectomy.

Original language	English
Pages (from-to)	58-61
Number of pages	4
Journal	American Journal of Surgery
Volume	234
DOIs	https://doi.org/10.1016/j.amjsurg.2024.03.022
Publication status	Published - Aug 2024

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@article{e0b5857a23974ad79db7fdc8e115a390,

title = "Tumour size predicts risk of recurrence in tall cell subtype papillary thyroid carcinoma",

abstract = "Background: The tall cell subtype of papillary thyroid cancer (TCPTC) is the most common aggressive subtype and often treated aggressively. This approach may not be necessary in smaller tumours without adverse histological characteristics. Methods: 97 patients with TCPTC defined as a height-to-width ratio of ≥3:1 and at least 30% tall cells were compared against 390 classical papillary thyroid carcinoma (CPTC) based on tumour size with recurrence free survival (RFS) as the primary outcome. Results: TCPTC are more likely to present with adverse histological characteristics. In smaller tumours (<2 cm), only central lymph node metastasis (HR7.16 p = 0.03) and multifocality (HR10.11 p = 0.026) increased recurrence risk. In larger tumours, TCPTC histology (HR3.78 p = 0.002), lymphovascular invasion (HR3.02 p = 0.014) and central lymph node metastasis (HR3.24 p < 0.001) significantly increased recurrence risk. Conclusion: TCPTC tumours <2 cm without central lymph node metastasis and multifocality are similar in risk of recurrence to classical PTC and could be managed with lobectomy.",

keywords = "Papillary thyroid carcinoma, Prognosis, Recurrence, Tall cell",

author = "David Leong and Connull Leslie and Brodie Laurie and Lachlan Hou and Jo Keyser and Yew, {Ming Khoon} and Simon Ryan and Hieu Nguyen and Dean Lisewski",

year = "2024",

month = aug,

doi = "10.1016/j.amjsurg.2024.03.022",

language = "English",

volume = "234",

pages = "58--61",

journal = "American Journal of Surgery",

issn = "0002-9610",

publisher = "Elsevier",

}

TY - JOUR

T1 - Tumour size predicts risk of recurrence in tall cell subtype papillary thyroid carcinoma

AU - Leong, David

AU - Leslie, Connull

AU - Laurie, Brodie

AU - Hou, Lachlan

AU - Keyser, Jo

AU - Yew, Ming Khoon

AU - Ryan, Simon

AU - Nguyen, Hieu

AU - Lisewski, Dean

PY - 2024/8

Y1 - 2024/8

N2 - Background: The tall cell subtype of papillary thyroid cancer (TCPTC) is the most common aggressive subtype and often treated aggressively. This approach may not be necessary in smaller tumours without adverse histological characteristics. Methods: 97 patients with TCPTC defined as a height-to-width ratio of ≥3:1 and at least 30% tall cells were compared against 390 classical papillary thyroid carcinoma (CPTC) based on tumour size with recurrence free survival (RFS) as the primary outcome. Results: TCPTC are more likely to present with adverse histological characteristics. In smaller tumours (<2 cm), only central lymph node metastasis (HR7.16 p = 0.03) and multifocality (HR10.11 p = 0.026) increased recurrence risk. In larger tumours, TCPTC histology (HR3.78 p = 0.002), lymphovascular invasion (HR3.02 p = 0.014) and central lymph node metastasis (HR3.24 p < 0.001) significantly increased recurrence risk. Conclusion: TCPTC tumours <2 cm without central lymph node metastasis and multifocality are similar in risk of recurrence to classical PTC and could be managed with lobectomy.

AB - Background: The tall cell subtype of papillary thyroid cancer (TCPTC) is the most common aggressive subtype and often treated aggressively. This approach may not be necessary in smaller tumours without adverse histological characteristics. Methods: 97 patients with TCPTC defined as a height-to-width ratio of ≥3:1 and at least 30% tall cells were compared against 390 classical papillary thyroid carcinoma (CPTC) based on tumour size with recurrence free survival (RFS) as the primary outcome. Results: TCPTC are more likely to present with adverse histological characteristics. In smaller tumours (<2 cm), only central lymph node metastasis (HR7.16 p = 0.03) and multifocality (HR10.11 p = 0.026) increased recurrence risk. In larger tumours, TCPTC histology (HR3.78 p = 0.002), lymphovascular invasion (HR3.02 p = 0.014) and central lymph node metastasis (HR3.24 p < 0.001) significantly increased recurrence risk. Conclusion: TCPTC tumours <2 cm without central lymph node metastasis and multifocality are similar in risk of recurrence to classical PTC and could be managed with lobectomy.

KW - Papillary thyroid carcinoma

KW - Prognosis

KW - Recurrence

KW - Tall cell

UR - http://www.scopus.com/inward/record.url?scp=85189453985&partnerID=8YFLogxK

U2 - 10.1016/j.amjsurg.2024.03.022

DO - 10.1016/j.amjsurg.2024.03.022

M3 - Review article

C2 - 38580566

AN - SCOPUS:85189453985

SN - 0002-9610

VL - 234

SP - 58

EP - 61

JO - American Journal of Surgery

JF - American Journal of Surgery

ER -

Tumour size predicts risk of recurrence in tall cell subtype papillary thyroid carcinoma

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