Survival with Follicular and Hurthle Cell Microcarcinoma Compared to Papillary Thyroid Microcarcinoma: A Population Study of 84,532 Patients

• Published in: World journal of surgery 2020-02, Vol.44 (2), p.469-478
• Main Authors: Khokar, Amna M., Holoubek, Simon A., Kuchta, Kristine M., Winchester, David J., Prinz, Richard A., Moo-Young, Tricia A.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adenoma, Oxyphilic - mortality; Adult; Aged; Carcinoma, Papillary - mortality; Cardiac Surgery; Female; General Surgery; Histology; Humans; Lymphatic Metastasis; Male; Medicine; Medicine & Public Health; Metastases; Metastasis; Middle Aged; Original Scientific Report; Population studies; Radiation; Regression analysis; Retrospective Studies; Surgery; Survival; Thoracic Surgery; Thyroid; Thyroid Epithelial Cells - pathology; Thyroid gland; Thyroid Neoplasms - mortality; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-019-05264-9

Background This study compares survival in patients with the rare subtypes of follicular (FTmC) and Hurthle cell (HCmC) microcarcinoma compared to that of papillary thyroid (PTmC) microcarcinoma. Methods Patients with FTmC and HCmC were selected from the National Cancer Database 2004–2015 and compared with PTmC. Patient clinicopathological characteristics and overall survival (OS) were analyzed. Multivariable logistic and Cox regression analysis evaluated binary outcomes and predictors of survival. A propensity score matched analysis using age, gender, race, extrathyroidal extension (ETE), nodal status, distant metastasis, radiation, and operation was performed to evaluate the difference in OS with FTmC, HCmC, and PTmC. Results We identified 858 FTmC, 476 HCmC, and 82,056 PTmC. FTmC was less likely to have macroscopic ETE compared to PTmC (2.6% vs. 3.1% p  = 0.03), but more likely to have distant metastasis (2.3% vs. 0.2%, p