Can minimally invasive follicular thyroid cancer be approached as a benign lesion? A population-level analysis of survival among 1,200 patients

Paolo Goffredo, Kevin Cheung, Sanziana A. Roman, Julie A. Sosa

Research output: Contribution to journalArticlepeer-review

52 Scopus citations

Abstract

Background: Minimally invasive follicular thyroid cancer (MIFC) is an encapsulated follicular tumor of low malignant potential. To date, histological criteria are still under debate, and there are no population-level data regarding characteristics and outcomes of patients with MIFC. Methods: Patients diagnosed with MIFC in the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2009 were included. Summary statistics were utilized to analyze patient characteristics; Kaplan-Meier analysis, and one-sample log-rank test were performed. Results: A total of 1,200 patients with MIFC and 4,208 with widely invasive follicular thyroid cancer (WIFC) were identified over 10 years of follow-up. MIFC was more common than WIFC in younger patients (mean age 49 vs. 52.3 years; p < 0.001). More patients with MIFC were alive at the end of follow-up (96.8 vs. 86.5 % WIFC; p < 0.001). Patients diagnosed with MIFC were less likely than those with WIFC to have lymph nodes involved and distant metastases (0.9 vs. 3.6 % and 0.5 vs. 8.9 %, respectively; both p < 0.001). Only 2 of 1,200 patients died of disease-specific causes; overall survival was comparable to the general US population (p = 0.16). Total thyroidectomy and RAI ablation were not associated with improvement in patient outcomes (p = 0.2 and 0.443, respectively). Conclusions: MIFC is associated with survival comparable to that of the normative US general population. Thyroid lobectomy alone may be considered adequate treatment in these patients.

Original languageEnglish (US)
Pages (from-to)767-772
Number of pages6
JournalAnnals of Surgical Oncology
Volume20
Issue number3
DOIs
StatePublished - Mar 2013
Externally publishedYes

Bibliographical note

Funding Information:
ACKNOWLEDGMENT The research was part of the EXTRAplus project, developed by the University of Milano-Bicocca (UNIMIB), Italy, and supported by the Cariplo Foundation, with active participation of Assolombarda (Lombardy Entrepreneurial Association).

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