Prognostic importance of histologic grading in papillary thyroid carcinoma.

Abstract:

BACKGROUND:The influence of various clinicopathologic features on survival of patients with papillary thyroid carcinoma has been examined. In particular, histologic grade, which was obtained by a combined assessment of nuclear atypia, tumor necrosis, and vascular invasion (VAN score) was studied. According to this, histologic grade is independent of growth pattern and differentiation of the tumor cells. METHODS:One hundred seventy-three consecutive patients were studied retrospectively, and most were treated with total/near-total thyroidectomy. Univariate (life-table) and multivariate (Cox regression) analyses of thyroid cancer deaths were performed. RESULTS:Histologic grade showed a highly significant prognostic impact. It was possible to discriminate between low-grade (Grade 1) and high-grade (Grade 2) tumors, occurring in 79% and 21% of the patients, respectively. The risk of thyroid cancer deaths was found to be considerably higher in the latter group of patients. When histologic grade was combined with sex and age, a highly significant prognostic score (the SAG score) was obtained. CONCLUSION:Histologic grade based on nuclear atypia, tumor necrosis, and vascular invasion is a strong and independent prognostic factor. When combined with patient sex and age, the final SAG score and the pTNM-age classification were both significant and should be considered in prognostic stratification of these patients.

journal_name

Cancer

journal_title

Cancer

authors

Akslen LA

doi

10.1002/1097-0142(19931101)72:9<2680::aid-cncr2820

subject

Has Abstract

pub_date

1993-11-01 00:00:00

pages

2680-5

issue

9

eissn

0008-543X

issn

1097-0142

journal_volume

72

pub_type

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