The following is a summary of “Role of the Degree of Vascular Invasion in Predicting Prognosis of Follicular Thyroid Carcinoma,” published in the May 2024 issue of Endocrinology by Yamazaki, et al.
For a study, researchers sought to identify prognostic factors for follicular thyroid carcinoma (FTC), incorporating histologic subtype and degree of vascular invasion (VI).
A retrospective cohort study reviewed records of 474 patients with FTC confirmed by surgical specimens at Ito Hospital from January 2005 to December 2014. The Cox proportional hazard model assessed factors associated with disease-free survival (DFS) and distant metastasis-free survival.
Among 474 patients, 140 (30%) had minimally invasive FTC, 260 (55%) had encapsulated angio-invasive FTC, and 74 (16%) had widely invasive FTC. Among 428 M0 patients with FTC, 10-year DFS rates were 97.3% for minimally invasive FTC (n = 133), 84.2% for encapsulated angio-invasive FTC (n = 247), and 69.9% for widely invasive FTC (n = 48) (P < .001). Multivariate analysis identified age ≥55 years (HR, 2.204; 95% CI, 1.223-3.969; P = .009), histologic subtype (HR, 2.068; 95% CI, 1.064-4.021; P = .032), VI ≥2 (HR, 6.814; 95% CI, 3.157-14.710; P < .001), and tumor size >40 mm (HR, 2.014; 95% CI, 1.089-3.727; P = .026) as independent negative prognostic factors for DFS.
Combining histologic subtype with VI ≥2, age ≥55, and tumor size >40 mm may enhance the accuracy of FTC prognosis stratification.
Reference: academic.oup.com/jcem/article-abstract/109/5/1291/7450930
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