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Prognostic significance of vascular invasion and cell-proliferation activity in widely invasive follicular carcinoma of the thyroid

2021; Japan Endocrine Society; Volume: 68; Issue: 8 Linguagem: Inglês

10.1507/endocrj.ej21-0064

1348-4540

Yasuhiro Ito, Mitsuyoshi Hirokawa, Makoto Fujishima, Hiroo Masuoka, Takuya Higashiyama, Minoru Kihara, Naoyoshi Onoda, Akihiro Miya, Akira Miyauchi,

Head and Neck Anomalies

Widely invasive follicular thyroid carcinoma (wi-FTC) is regarded as having an aggressive character and a dire prognosis, but it has not been known whether all wi-FTCs have a dire prognosis. Herein we retrospectively analyzed the cases of 133 patients with wi-FTCs to determine the prognostic significance of vascular invasion and cell-proliferation activity based on the Ki-67 labeling index (LI). Of the 119 patients without distant metastasis (M0), 11 (9.2%) showed recurrence during the postoperative follow-up. In a univariate analysis, the recurrence-free survival (RFS) rates of the M0 patients with vascular invasion and those with a Ki-67 LI ≥5% were significantly poorer (p = 0.0013 and p = 0.0268, respectively) than those of the patients without vascular invasion or with a Ki-67 LI 5% did not (p = 0.1348). To date, only five patients have died of their thyroid carcinoma; four cases were M1. In conclusion, although M0 wi-FTC generally has a favorable prognosis, cases with positive vascular invasion or a high Ki-67 LI are likely to recur, and careful postoperative follow-up is necessary.