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KMID : 1141520210360051078
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Endocrinology and Metabolism
2021 Volume.36 No. 5 p.1078 ~ p.1085
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Clinicopathological Characteristics and Disease-Free Survival in Patients with Hurthle Cell Carcinoma: A Multicenter Cohort Study in South Korea
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Jin Meihua
Kim Eun-Sook
Kim Bo-Hyun
Kim Hee-Kyung
Kang Yea-Eun
Jeon Min-Ji
Kim Tae-Yong
Kang Ho-Cheol
Kim Won-Bae
Shong Young-Kee
Kim Mi-Jin
Kim Won-Gu
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Abstract
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Background: Hurthle cell carcinoma (HCC), a type of thyroid carcinoma, is rare in South Korea, and few studies have investigated its prognosis.
Methods: This long-term multicenter retrospective cohort study evaluated the clinicopathological features and clinical outcomes in patients with HCC who underwent thyroid surgery between 1996 and 2009.
Results: The mean age of the 97 patients included in the study was 50.3 years, and 26.8% were male. The mean size of the primary tumor was 3.2±1.8 cm, and three (3.1%) patients had distant metastasis at initial diagnosis. Ultrasonographic findings were available for 73 patients; the number of nodules with low-, intermediate-, and high suspicion was 28 (38.4%), 27 (37.0%), and 18 (24.7%), respectively, based on the Korean-Thyroid Imaging Reporting and Data System. Preoperatively, follicular neoplasm (FN) or suspicion for FN accounted for 65.2% of the cases according to the Bethesda category, and 13% had malignancy or suspicious for malignancy. During a median follow-up of 8.5 years, eight (8.2%) patients had persistent/recurrent disease, and none died of HCC. Older age, gross extrathyroidal extension (ETE), and widely invasive types of tumors were significantly associated with distant metastasis (all P<0.01). Gross ETE (hazard ratio [HR], 27.7; 95% confidence interval [CI], 2.2 to 346.4; P=0.01) and widely invasive classification (HR, 6.5; 95% CI, 1.1 to 39.4; P=0.04) were independent risk factors for poor disease-free survival (DFS).
Conclusion: The long-term prognosis of HCC is relatively favorable in South Korea from this study, although this is not a nation-wide data, and gross ETE and widely invasive cancer are significant prognostic factors for DFS. The diagnosis of HCC by ultrasonography and cytopathology remains challenging.
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KEYWORD
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Thyroid cancer, Hurthle cell carcinoma, Ultrasonography, Prognosis, Recurrence
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