Prognostic significance of vascular invasion and cell-proliferation activity in widely invasive follicular carcinoma of the thyroid.

Abstract

Widely invasive follicular thyroid carcinoma (wi-FTC) is regarded as having an aggressive character and a dire prognosis, but it has not been known whether all wi-FTCs have a dire prognosis. Herein we retrospectively analyzed the cases of 133 patients with wi-FTCs to determine the prognostic significance of vascular invasion and cell-proliferation activity based on the Ki-67 labeling index (LI). Of the 119 patients without distant metastasis (M0), 11 (9.2%) showed recurrence during the postoperative follow-up. In a univariate analysis, the recurrence-free survival (RFS) rates of the M0 patients with vascular invasion and those with a Ki-67 LI ≥5% were significantly poorer (p = 0.0013 and p = 0.0268, respectively) than those of the patients without vascular invasion or with a Ki-67 LI <5%. Other clinicopathological factors such as patient age, gender, tumor size, and oxyphilic tumor were not significantly related to the patients' RFS. In a multivariate analysis, positive vascular invasion independently affected the RFS (p = 0.0133), but Ki-67 >5% did not (p = 0.1348). To date, only five patients have died of their thyroid carcinoma; four cases were M1. In conclusion, although M0 wi-FTC generally has a favorable prognosis, cases with positive vascular invasion or a high Ki-67 LI are likely to recur, and careful postoperative follow-up is necessary.

• Authors: Yasuhiro Ito, Mitsuhiro Hirokawa, Makoto Fujishima, Hiroo Masuoka, Takuya Higashiyama, Minoru Kihara, Naoyoshi Onoda, Akihiro Miya, Akira Miyauchi
• Journal: Endocrine journal (Endocr J) Vol. 68 Issue 8 Pg. 881-888 (Aug 28 2021) ISSN: 1348-4540 [Electronic] Japan
• PMID: 33746136 (Publication Type: Journal Article)

Topics

• Adenocarcinoma, Follicular (pathology)
• Adult
• Age Factors
• Cell Proliferation (physiology)
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Invasiveness (pathology)
• Neoplasm Recurrence, Local (pathology)
• Neovascularization, Pathologic (pathology)
• Prognosis
• Thyroid Gland (pathology)
• Thyroid Neoplasms (pathology)