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Original Article
Clinical Study
Clinical Implication of World Health Organization Classification in Patients with Follicular Thyroid Carcinoma in South Korea: A Multicenter Cohort Study
Meihua Jin, Eun Sook Kim, Bo Hyun Kim, Hee Kyung Kim, Hyon-Seung Yi, Min Ji Jeon, Tae Yong Kim, Ho-Cheol Kang, Won Bae Kim, Young Kee Shong, Mijin Kim, Won Gu Kim
Endocrinol Metab. 2020;35(3):618-627.   Published online September 22, 2020
DOI: https://doi.org/10.3803/EnM.2020.742
  • 5,418 View
  • 121 Download
  • 8 Web of Science
  • 9 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
The study aimed to compare the prognostic value of the 4th edition of World Health Organization classification (WHO-2017) with the previous WHO classification (WHO-2004) for follicular thyroid carcinoma (FTC).
Methods
This multicenter retrospective cohort study included 318 patients with FTC from five tertiary centers who underwent thyroid surgery between 1996 and 2009. We evaluated the prognosis of patients with minimally invasive (MI), encapsulated angioinvasive (EA), and widely invasive (WI) FTC according to WHO-2017. Further, we evaluated the proportion of variation explained (PVE) and Harrell’s C-index to compare the predictability of disease-free survival (DFS) and disease-specific survival (DSS).
Results
In total, 227, 58, and 33 patients had MI-, EA-, and WI-FTC, respectively. During a median follow-up of 10.6 years, 46 (14.5%) patients had disease recurrence and 20 (6.3%) patients died from FTC. The 10-year DFS rates of patients with MI-, EA-, and WI-FTC were 91.1%, 78.2%, and 54.9%, respectively (P<0.001, PVE=7.1%, C-index=0.649). The corresponding 10-year DSS rates were 95.9%, 93.5%, and 73.5%, respectively (P<0.001, PVE=2.6%, C-index=0.624). The PVE and C-index values were higher using WHO-2017 than using WHO-2004 for the prediction of DFS, but not for DSS. In multivariate analysis, older age (P=0.02), gross extrathyroidal extension (ETE) (P=0.003), and distant metastasis (P<0.001) were independent risk factors for DSS.
Conclusion
WHO-2017 improves the predictability of DFS, but not DSS, in patients with FTC. Distant metastasis, gross ETE and older age (≥55 years) were independent risk factors for DSS.

Citations

Citations to this article as recorded by  
  • Association of Ultrasonography Features of Follicular Thyroid Carcinoma With Tumor Invasiveness and Prognosis Based on WHO Classification and TERT Promoter Mutation
    Myoung Kyoung Kim, Hyunju Park, Young Lyun Oh, Jung Hee Shin, Tae Hyuk Kim, Soo Yeon Hahn
    Korean Journal of Radiology.2024; 25(1): 103.     CrossRef
  • Clinical Outcomes and Implications of Radioactive Iodine Therapy on Cancer-specific Survival in WHO Classification of FTC
    Genpeng Li, Ziyang Ye, Tao Wei, Jingqiang Zhu, Zhihui Li, Jianyong Lei
    The Journal of Clinical Endocrinology & Metabolism.2024;[Epub]     CrossRef
  • Radioiodine whole body scan pitfalls in differentiated thyroid cancer
    Cristina Basso, Alessandra Colapinto, Valentina Vicennati, Alessandra Gambineri, Carla Pelusi, Guido Di Dalmazi, Elisa Lodi Rizzini, Elena Tabacchi, Arber Golemi, Letizia Calderoni, Stefano Fanti, Uberto Pagotto, Andrea Repaci
    Endocrine.2024;[Epub]     CrossRef
  • The Prognostic Impact of Extent of Vascular Invasion in Follicular Thyroid Carcinoma
    David Leong, Anthony J. Gill, John Turchini, Michael Waller, Roderick Clifton‐Bligh, Anthony Glover, Mark Sywak, Stan Sidhu
    World Journal of Surgery.2023; 47(2): 412.     CrossRef
  • TERT Promoter Mutation as a Prognostic Marker in Encapsulated Angioinvasive and Widely Invasive Follicular Thyroid Carcinomas
    Yasuhiro Ito, Takashi Akamizu
    Clinical Thyroidology.2023; 35(5): 202.     CrossRef
  • Risk factors for death of follicular thyroid carcinoma: a systematic review and meta-analysis
    Ting Zhang, Liang He, Zhihong Wang, Wenwu Dong, Wei Sun, Ping Zhang, Hao Zhang
    Endocrine.2023; 82(3): 457.     CrossRef
  • Molecular classification of follicular thyroid carcinoma based on TERT promoter mutations
    Hyunju Park, Hyeong Chan Shin, Heera Yang, Jung Heo, Chang-Seok Ki, Hye Seung Kim, Jung-Han Kim, Soo Yeon Hahn, Yun Jae Chung, Sun Wook Kim, Jae Hoon Chung, Young Lyun Oh, Tae Hyuk Kim
    Modern Pathology.2022; 35(2): 186.     CrossRef
  • Whole-genome Sequencing of Follicular Thyroid Carcinomas Reveal Recurrent Mutations in MicroRNA Processing Subunit DGCR8
    Johan O Paulsson, Nima Rafati, Sebastian DiLorenzo, Yi Chen, Felix Haglund, Jan Zedenius, C Christofer Juhlin
    The Journal of Clinical Endocrinology & Metabolism.2021; 106(11): 3265.     CrossRef
  • Clinicopathological Characteristics and Disease-Free Survival in Patients with Hürthle Cell Carcinoma: A Multicenter Cohort Study in South Korea
    Meihua Jin, Eun Sook Kim, Bo Hyun Kim, Hee Kyung Kim, Yea Eun Kang, Min Ji Jeon, Tae Yong Kim, Ho-Cheol Kang, Won Bae Kim, Young Kee Shong, Mijin Kim, Won Gu Kim
    Endocrinology and Metabolism.2021; 36(5): 1078.     CrossRef
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Case Report
A Case of Thyroid Hemiagenesis with Papillary Adenocarcinoma.
Je Ho Han, Bong Yun Cha, Ho Young Son, Yoo Bae Ahn, Kwang Woo Lee, Sung Koo Kang, Se Jeong Oh, Jong Soon Na, Sang Ah Jang, Moo Il Kang
J Korean Endocr Soc. 1994;9(4):385-389.   Published online November 6, 2019
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  • 20 Download
AbstractAbstract PDF
Variation in the gross anatomy of the thyroid is relatively common. Although thyroid hemiagenesis is considered to be a rare congenital anomaly, its incidence is probably underestimated because the diagnosis is usually incidental.We present the case of a 26-year-old woman with right thyroid hemiagenesis associated with papillary adenocarcinoma. The diagnosis of hemiagenesis was established by isotope imaging, which showed hot nodule, thyroid ultrasonography and surgical exploration for proper management of a nodule in the left lobe of thyroid gland. As she was diagnosed to have papillary adenocarcinoma, total thyroidectomy was performed and at present she remains disease-free.
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