Thyroid Research Thyroid Research Archive Thyroid Cancer

Similar outcome in patients with Hurthle-cell carcinoma and follicular carcinoma

(July 2003)

The background of the study. The clinical and pathologic determinants of prognosis in patients with Hurthle-cell carcinomas are poorly understood, and whether their prognosis differs from that of patients with follicular carcinoma is debated. This retrospective study was done to determine the features of Hurthle-cell carcinoma and prognosis in a national cohort of patients, and the results were compared with a matched group of patients with follicular carcinoma.

Patient Selection and Characteristics. All cases of Hurthle-cell carcinoma entered in the Surveillance, Epidemiology and End Results database from 1973 to 1998 were reviewed. This database contains cancer incidence and survival data from 11 cancer registries throughout the United States. Among 20,025 patients with thyroid carcinoma recorded in this database during this period, 555 (3 percent) had a Hurthle-cell carcinoma. There were 377 women (68 percent) and 178 men (32 percent); the average age at diagnosis was 56 years. The mean tumor size was 3.5 cm; most patients (84 percent) had only thyroid disease, but 16 percent had invasion of structures in the neck.

The outcome in 411 of the patients with Hurthle-cell carcinoma was compared with that of 411 patients with follicular carcinoma of the same age, sex, tumor size, extent of local extension, and year of diagnosis.

The results of the study. The 10-year mortality rate was approximately 20 percent in women and 45 percent in men, and was highest in older men with large tumors. The overall 5- and 10-year mortality rates in the patients with Hurthle-cell carcinoma were 15 percent and 29 percent, respectively, as compared with 11 percent and 45 percent, respectively, in the patients with follicular carcinoma. The mean survival time in the patients with Hurthle-cell carcinoma was 109 months, as compared with 113 months in the patients with follicular carcinoma.

The conclusions of the study. Among patients with Hurthle-cell carcinoma, male sex, older age, large tumor size, and major extension indicate a poor prognosis. The mortality rate is similar among patients with Hurthle-cell carcinoma and matched patients with follicular carcinoma.

The original article. Bhattacharyya N. Survival and prognosis in Hurthle cell carcinoma of the thyroid gland. Arch Otolaryngol Head Neck Surg 2003;129:207-10.