Literature DB >> 31098668

Prognostic Impact of the Turin Criteria in Poorly Differentiated Thyroid Carcinoma.

Junko Akaishi1, Tetsuo Kondo2, Kiminori Sugino3, Yuna Ogimi3, Chie Masaki3, Kiyomi Y Hames3, Tomonori Yabuta3, Chisato Tomoda3, Akifumi Suzuki3, Kenichi Matsuzu3, Takashi Uruno3, Keiko Ohkuwa3, Wataru Kitagawa3, Mitsuji Nagahama3, Ryohei Katoh4, Koichi Ito3.   

Abstract

BACKGROUND: The Turin criteria including solid, trabecular, and/or insular architecture, lack of typical nuclear features of papillary carcinoma, and mitoses, necrosis, or convoluted nuclei were adopted in the recent 4th edition of the World Health Organization classification published in 2017.
MATERIALS AND METHODS: Between 2006 and 2017, 11,001 cases underwent initial surgery for primary malignant thyroid tumor derived from follicular cells. A total of 75 (0.7%) cases were diagnosed with PDTC according to the 2004 WHO classification. Based on the Turin criteria, 30 (40%) cases were re-classified as PDTC-Turin (+) and 45 (60%) cases were PDTC-Turin (-). Clinicopathological features and prognosis were compared between PDTC-Turin (+) and PDTC-Turin (-).
RESULTS: Seventy-five patients (48 females and 27 males) had a median age at the time of surgery of 57 years. Preoperative diagnosis was benign in 16 (21%), follicular tumor in 40 (53%), and malignant in 19 (25%). The 5-year cause-specific survival (CSS) and disease-free survival (DFS) rates were 97% and 44% for PDTC-Turin (+) and 100% and 88% for PDTC-Turin (-). On univariate analysis, CSS and DFS rates were significantly worse in the PDTC-Turin (+) than in the PDTC-Turin (-) (p = 0.0096, and p = 0.0016). Multivariate analysis showed that Turin criteria status, Ki-67 labeling index ≥ 10%, and age 55 ≥ years were the independent prognostic factors for recurrence.
CONCLUSIONS: The prevalence of PDTC diagnosed with the Turin criteria was low, but it showed more aggressive behavior. The 2017 WHO classification reflects the prognosis more accurately than the 2004 WHO classification.

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Year:  2019        PMID: 31098668     DOI: 10.1007/s00268-019-05028-5

Source DB:  PubMed          Journal:  World J Surg        ISSN: 0364-2313            Impact factor:   3.352


  37 in total

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