Thyroid Research Thyroid Research Archive Thyroid Cancer

The prognosis of patients with diffuse sclerosing papillary carcinoma is poorer than that of patients with classical papillary carcinoma

(July 2006)

The background of the study. There are several subtypes of papillary thyroid carcinoma, including classical, follicular variant, and diffuse sclerosing carcinoma. The latter subtype is rare, and little is known about its behavior. In this study, the characteristics and course of patients with this type of tumor were compared with those of patients with classical papillary carcinoma.

How the study was done. From 1992 to 2000, 83 patients with diffuse sclerosing papillary carcinoma and 168 patients with classical papillary carcinoma were treated and followed at a single center. All the patients were treated by total thyroidectomy, and many underwent lymph-node dissection and were treated with radioiodine. Demographic, clinical, pathologic, and follow-up information were collected for each patient.

The results of the study. The mean duration of follow-up was 7.6 years (range, 4 to 10). During follow-up, 13 (16 percent) of the patients with diffuse sclerosing papillary carcinoma had a recurrence in lymph nodes in their neck, 6 (7 percent) had distant spread of tumor, and 3 (4 percent) dies of tumor-related causes The respective figures in the patients with classical papillary carcinoma were 6 (4 percent), 2 (1 percent), and 1 (1 percent). The rates of recurrence and mortality were statistically significantly higher in the patients with diffuse sclerosing papillary carcinoma.

The conclusions of the study. Patients with diffuse sclerosing papillary carcinoma have lymph-node and distant metastases and die of their tumor more often than patients with classical papillary carcinoma.

The original article Falvo L, Giacomelli L, D’Andrea V, Marzullo A, Guerriero G, de Antoni E. Prognostic importance of sclerosing variant in papillary thyroid carcinoma. Am Surg 2006;72:438-44.