Pasqualino Malandrino1, Marco Russo2, Concetto Regalbuto1, Gabriella Pellegriti1, Mariacarla Moleti2, Andrea Caff1, Sebastiano Squatrito1, Riccardo Vigneri1,3,4. 1. 1 Endocrinology, Department of Clinical and Experimental Medicine, University of Catania , Garibaldi-Nesima Medical Center, Catania, Italy . 2. 2 Endocrinology, Department of Clinical and Experimental Medicine, University of Messina , Policlinico "G. Martino," Messina, Italy . 3. 3 Humanitas, Catania Oncology Center , Catania, Italy . 4. 4 Institute of Biostructures and Bioimaging , CNR (National Research Council), Catania, Italy .
Abstract
INTRODUCTION: The diffuse sclerosing variant (DSV) of papillary thyroid cancer (PTC) is considered an aggressive histotype associated with poor prognosis. However, the available data for both the outcome and best management of this disease are inconsistent. METHODS: This study reviewed the current literature by searching PubMed up to November 30, 2015, using the search terms "diffuse sclerosing variant" and "papillary thyroid cancer (or carcinoma)" and selecting only studies evaluating recurrent/persistent disease and cancer-related mortality in both DSV and classic PTC (cPTC). The association with some features of aggressiveness at diagnosis, the risk of recurrence or persistence, and the risk of cancer-related death were reported as odds ratio (OR) with confidence intervals (CI). Meta-regression analysis was used to assess the effect of covariates across the studies. RESULTS: Ten studies met the eligibility criteria and contributed 585 DSV and 64,611 cPTC patients. Relative to patients with cPTC, patients with DSV exhibited a higher risk of extrathyroidal extension and lymph node and distant metastases. The risk of persistent/recurrent disease was three times higher in patients with DSV than it was in cPTC patients (OR = 3.19 [CI 1.86-5.49]). This risk was not different when only studies where post-surgical (131)I was routinely administered were considered (OR = 2.07 [CI 0.88-4.90]). The risk of cancer-related mortality was not different between DSV and cPTC (OR = 1.34 [CI 0.76-2.38]). CONCLUSIONS: This meta-analysis confirms the aggressive biological behavior of DSV thyroid cancer. When preoperatively suspected, total thyroidectomy with lymph node excision followed by radioiodine therapy should be the correct management for DSV.
INTRODUCTION: The diffuse sclerosing variant (DSV) of papillary thyroid cancer (PTC) is considered an aggressive histotype associated with poor prognosis. However, the available data for both the outcome and best management of this disease are inconsistent. METHODS: This study reviewed the current literature by searching PubMed up to November 30, 2015, using the search terms "diffuse sclerosing variant" and "papillary thyroid cancer (or carcinoma)" and selecting only studies evaluating recurrent/persistent disease and cancer-related mortality in both DSV and classic PTC (cPTC). The association with some features of aggressiveness at diagnosis, the risk of recurrence or persistence, and the risk of cancer-related death were reported as odds ratio (OR) with confidence intervals (CI). Meta-regression analysis was used to assess the effect of covariates across the studies. RESULTS: Ten studies met the eligibility criteria and contributed 585 DSV and 64,611 cPTCpatients. Relative to patients with cPTC, patients with DSV exhibited a higher risk of extrathyroidal extension and lymph node and distant metastases. The risk of persistent/recurrent disease was three times higher in patients with DSV than it was in cPTCpatients (OR = 3.19 [CI 1.86-5.49]). This risk was not different when only studies where post-surgical (131)I was routinely administered were considered (OR = 2.07 [CI 0.88-4.90]). The risk of cancer-related mortality was not different between DSV and cPTC (OR = 1.34 [CI 0.76-2.38]). CONCLUSIONS: This meta-analysis confirms the aggressive biological behavior of DSV thyroid cancer. When preoperatively suspected, total thyroidectomy with lymph node excision followed by radioiodine therapy should be the correct management for DSV.
Authors: M Russo; P Malandrino; M Moleti; F Vermiglio; M A Violi; I Marturano; E Minaldi; R Vigneri; G Pellegriti; C Regalbuto Journal: J Endocrinol Invest Date: 2017-05-20 Impact factor: 4.256
Authors: Sunghwan Suh; Tae Sik Goh; Yun Hak Kim; Sae-Ock Oh; Kyoungjune Pak; Ju Won Seok; In Joo Kim Journal: Endocrinol Metab (Seoul) Date: 2020-06-24
Authors: Andrés Coca-Pelaz; Jatin P Shah; Juan C Hernandez-Prera; Ronald A Ghossein; Juan P Rodrigo; Dana M Hartl; Kerry D Olsen; Ashok R Shaha; Mark Zafereo; Carlos Suarez; Iain J Nixon; Gregory W Randolph; Antti A Mäkitie; Luiz P Kowalski; Vincent Vander Poorten; Alvaro Sanabria; Orlando Guntinas-Lichius; Ricard Simo; Peter Zbären; Peter Angelos; Avi Khafif; Alessandra Rinaldo; Alfio Ferlito Journal: Adv Ther Date: 2020-06-01 Impact factor: 3.845