We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Tall cell percentage alone in PTC without aggressive features should not guide patients' clinical management.
- Authors
Poma, Anello Marcello; Viola, David; Macerola, Elisabetta; Proietti, Agnese; Molinaro, Eleonora; De Vietro, Dario; Elisei, Rossella; Materazzi, Gabriele; Miccoli, Paolo; Basolo, Fulvio; Ugolini, Clara
- Abstract
Context: Recent diagnostic criteria updates of the tall cell variant of papillary thyroid carcinoma (TCPTC) by the World Health Organization (WHO) have determined the inclusion of tumors with 30% to 49% of tall cells. However, the impact of tall cell percentage on papillary thyroid carcinoma (PTC) patients' prognosis is still debated. Objective: We aimed to evaluate whether tall cell percentage affects patient outcome in the absence of aggressive features. Methods: Rates of aggressive features, recurrence-free survival (RFS), and distant RFS (5-year median follow-up) were compared among tumors with less than 30%, 30% to 49% and at least 50% tall cells. We also evaluated the impact of the new tall cell cutoff on patient management. Results: Overall, 3092 tumors (15.7% of all PTCs) were collected: A total of 792 PTCs had less than 30%, 503 had 30% to 49%, and 1797 had 50% or more tall cell areas. With the new WHO definition, the number of TCPTCs increased by 28%. There were no differences in recurrence rates according to tall cell percentage. The coexistence of BRAF and TERT promoter mutations predicted a worse RFS. Considering the new definition of TCPTC, the level of risk according to the American Thyroid Association increased from low to intermediate in 4.2% of cases. However, the recurrence rate within this subgroup was comparable to low risk. Conclusion: TCPTC and PTC with tall cell areas can be considered as a unique group with similar recurrence risk. However, whenever aggressive features are absent, tumors have a low risk of recurrence independently of tall cell percentage.
- Subjects
THYROID cancer; WORLD Health Organization; HEALTH management
- Publication
Journal of Clinical Endocrinology & Metabolism, 2021, Vol 106, Issue 10, pe4109
- ISSN
0021-972X
- Publication type
Article
- DOI
10.1210/clinem/dgab388