Andrés Coca-Pelaz1, Juan P Rodrigo2, Jatin P Shah3, Alvaro Sanabria4, Abir Al Ghuzlan5, Carl E Silver6, Ashok R Shaha3, Peter Angelos7, Dana M Hartl8,9, Antti A Mäkitie10, Kerry D Olsen11, Randall P Owen12, Gregory W Randolph13, Ricard Simó14, Ralph P Tufano15, Luiz P Kowalski16, Mark E Zafereo15, Alessandra Rinaldo17, Alfio Ferlito18. 1. Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, Oviedo, Spain. acocapelaz@yahoo.es. 2. Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, Oviedo, Spain. 3. Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 4. Department of Surgery, School of Medicine, Universidad de Antioquia/IPS Universitaria-Clinica Las Vegas-QUIRON-CEXCA Centro de Excelencia en Enfermedades de Cabeza y Cuello, Medellín, Colombia. 5. Department of Medical Biology and Pathology, Institut Gustave Roussy, UMS3655-INSERM US23 AMMICA, Université Paris-Saclay and Experimental and Translational Pathology Platform, CNRS, Villejuif, France. 6. Department of Surgery, University of Arizona College of Medicine, Phoenix, AZ, USA. 7. Department of Surgery and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL, USA. 8. Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif Cedex, France. 9. Laboratoire de Phonétique et de Phonologie, Paris, France. 10. Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 11. Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, USA. 12. Division of Surgical Oncology, Department of Surgery, Mount Sinai School of Medicine, New York, NY, USA. 13. Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA. 14. Head and Neck and Thyroid Oncology Unit, Department of Otorhinolaryngology, Head and Neck Surgery, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK. 15. Head and Neck Endocrine Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 16. Department of Otorhinolaryngology-Head and Neck Surgery, A.C. Camargo Cancer Center and University of Sao Paulo Medical School, São Paulo, Brazil. 17. University of Udine School of Medicine, Udine, Italy. 18. Coordinator of the International Head and Neck Scientific Group, Padua, Italy.
Abstract
INTRODUCTION: Hürthle cell carcinoma (HCC) comprises about 5% of thyroid carcinoma cases. Partly because of its rarity there is much we still need to know about HCC as compared to other histological cancer subtypes. METHODS: We conducted a systematic literature review following PRISMA guidelines and meta-analysis, from 2000 to 2020, to investigate the main characteristics of HCC and clarify information concerning tumor behavior and treatment. RESULTS: Our review included data from 9638 patients reported in 27 articles over the past 20 years. This tumor occurred more frequently in women (67.5%). The mean age was 57.6 years, and the mean size of the neoplasm at diagnosis was 30 mm. Extrathyroidal extension was common (24%) but lymph node metastasis was not (9%). Total thyroidectomy was the most common surgical approach, with neck dissection usually performed in cases with clinically apparent positive neck nodes. Radioiodine therapy was frequently applied (54%), although there is no consensus about its benefits. The mean 5- and 10-year overall survival was 91% and 76%, respectively. CONCLUSION: This review serves to further elucidate the main characteristics of this malignancy. HCC of the thyroid is rare and most often presents with a relatively large nodule, whereas lymph node metastases are rare. Given the rarity of HCC, a consensus on their treatment is needed, as doubts remain concerning the role of specific tumor findings and their influence on management.
INTRODUCTION: Hürthle cell carcinoma (HCC) comprises about 5% of thyroid carcinoma cases. Partly because of its rarity there is much we still need to know about HCC as compared to other histological cancer subtypes. METHODS: We conducted a systematic literature review following PRISMA guidelines and meta-analysis, from 2000 to 2020, to investigate the main characteristics of HCC and clarify information concerning tumor behavior and treatment. RESULTS: Our review included data from 9638 patients reported in 27 articles over the past 20 years. This tumor occurred more frequently in women (67.5%). The mean age was 57.6 years, and the mean size of the neoplasm at diagnosis was 30 mm. Extrathyroidal extension was common (24%) but lymph node metastasis was not (9%). Total thyroidectomy was the most common surgical approach, with neck dissection usually performed in cases with clinically apparent positive neck nodes. Radioiodine therapy was frequently applied (54%), although there is no consensus about its benefits. The mean 5- and 10-year overall survival was 91% and 76%, respectively. CONCLUSION: This review serves to further elucidate the main characteristics of this malignancy. HCC of the thyroid is rare and most often presents with a relatively large nodule, whereas lymph node metastases are rare. Given the rarity of HCC, a consensus on their treatment is needed, as doubts remain concerning the role of specific tumor findings and their influence on management.
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