Prevalence and aggressiveness of papillary thyroid carcinoma in surgically-treated graves’ disease patients: a retrospective matched cohort study
Abstract Background Reported rates of thyroid cancer in Graves’ disease (GD) vary widely. The aim of this study was to evaluate the prevalence of papillary thyroid carcinoma (PTC), including aggressive forms, in GD compared to matched controls undergoing thyroidectomy. Furthermore, it seeks to eluci...
Main Authors: | , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2019-08-01
|
Series: | Journal of Otolaryngology - Head and Neck Surgery |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s40463-019-0364-5 |
id |
doaj-8c20fbb3a120422ebb74817a4a3ac795 |
---|---|
record_format |
Article |
spelling |
doaj-8c20fbb3a120422ebb74817a4a3ac7952020-11-25T03:43:33ZengBMCJournal of Otolaryngology - Head and Neck Surgery1916-02162019-08-014811710.1186/s40463-019-0364-5Prevalence and aggressiveness of papillary thyroid carcinoma in surgically-treated graves’ disease patients: a retrospective matched cohort studyEunice You0Marco A. Mascarella1Abrar Al Jassim2Veronique-Isabelle Forest3Michael P. Hier4Michael Tamilia5Marc Pusztaszeri6Richard J. Payne7McGill UniversityMcGill Department of Otolaryngology – Head and Neck Surgery, Jewish General HospitalMcGill UniversityMcGill UniversityMcGill UniversityMcGill UniversityMcGill UniversityMcGill UniversityAbstract Background Reported rates of thyroid cancer in Graves’ disease (GD) vary widely. The aim of this study was to evaluate the prevalence of papillary thyroid carcinoma (PTC), including aggressive forms, in GD compared to matched controls undergoing thyroidectomy. Furthermore, it seeks to elucidate any patient- or tumour-associated factors predictive of malignancy or an aggressive course. Methods We performed a matched cohort study of GD patients undergoing thyroidectomy at our institution between 2006 to 2018. Clinicodemographic factors, preoperative characteristics, surgical factors, final histopathology as well postoperative course were collected. Aggressive PTC was defined as evidence of lymph node metastasis, extrathyroidal extension, gross vascular invasion and/or aggressive histologic variants. Prevalence of PTC was compared with sex, age and nodule size-matched euthyroid patients that underwent thyroidectomy in the same time period. Results A total of 132 patients were included in the study with a mean age of 46 (±14) years. Malignancy was identified in 36/66 (55%) patients with GD; 20/66 (30%) were incidental carcinomas and 9/66 (14%) were associated with aggressive pathologic features. In the aggressive group, lymph node metastasis to the central compartment was present in 8 (12%) cases, extrathyroidal extension in 4 (6%) cases and one (1.5%) patient had a diffuse sclerosing tumor variant. No significant differences in outcome were found between the two groups. GD patients were more likely to have incidental carcinomas (p = 0.035). Adjusting for baseline patient characteristics, GD patients demonstrated an increased likelihood of harbouring a malignancy (odds ratio (OR) = 2.67; 95% confidence interval (CI) 1.00–7.18) compared to controls. Conclusion More than half of patients with GD undergoing thyroidectomy had concurrent thyroid malignancy with aggressive features present in 14% of patients. GD may confer a heightened risk of thyroid cancer; thyroid nodules should therefore be carefully investigated.http://link.springer.com/article/10.1186/s40463-019-0364-5Graves’ diseasePapillary thyroid carcinomaAggressive carcinomaMatched cohortOutcomes |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Eunice You Marco A. Mascarella Abrar Al Jassim Veronique-Isabelle Forest Michael P. Hier Michael Tamilia Marc Pusztaszeri Richard J. Payne |
spellingShingle |
Eunice You Marco A. Mascarella Abrar Al Jassim Veronique-Isabelle Forest Michael P. Hier Michael Tamilia Marc Pusztaszeri Richard J. Payne Prevalence and aggressiveness of papillary thyroid carcinoma in surgically-treated graves’ disease patients: a retrospective matched cohort study Journal of Otolaryngology - Head and Neck Surgery Graves’ disease Papillary thyroid carcinoma Aggressive carcinoma Matched cohort Outcomes |
author_facet |
Eunice You Marco A. Mascarella Abrar Al Jassim Veronique-Isabelle Forest Michael P. Hier Michael Tamilia Marc Pusztaszeri Richard J. Payne |
author_sort |
Eunice You |
title |
Prevalence and aggressiveness of papillary thyroid carcinoma in surgically-treated graves’ disease patients: a retrospective matched cohort study |
title_short |
Prevalence and aggressiveness of papillary thyroid carcinoma in surgically-treated graves’ disease patients: a retrospective matched cohort study |
title_full |
Prevalence and aggressiveness of papillary thyroid carcinoma in surgically-treated graves’ disease patients: a retrospective matched cohort study |
title_fullStr |
Prevalence and aggressiveness of papillary thyroid carcinoma in surgically-treated graves’ disease patients: a retrospective matched cohort study |
title_full_unstemmed |
Prevalence and aggressiveness of papillary thyroid carcinoma in surgically-treated graves’ disease patients: a retrospective matched cohort study |
title_sort |
prevalence and aggressiveness of papillary thyroid carcinoma in surgically-treated graves’ disease patients: a retrospective matched cohort study |
publisher |
BMC |
series |
Journal of Otolaryngology - Head and Neck Surgery |
issn |
1916-0216 |
publishDate |
2019-08-01 |
description |
Abstract Background Reported rates of thyroid cancer in Graves’ disease (GD) vary widely. The aim of this study was to evaluate the prevalence of papillary thyroid carcinoma (PTC), including aggressive forms, in GD compared to matched controls undergoing thyroidectomy. Furthermore, it seeks to elucidate any patient- or tumour-associated factors predictive of malignancy or an aggressive course. Methods We performed a matched cohort study of GD patients undergoing thyroidectomy at our institution between 2006 to 2018. Clinicodemographic factors, preoperative characteristics, surgical factors, final histopathology as well postoperative course were collected. Aggressive PTC was defined as evidence of lymph node metastasis, extrathyroidal extension, gross vascular invasion and/or aggressive histologic variants. Prevalence of PTC was compared with sex, age and nodule size-matched euthyroid patients that underwent thyroidectomy in the same time period. Results A total of 132 patients were included in the study with a mean age of 46 (±14) years. Malignancy was identified in 36/66 (55%) patients with GD; 20/66 (30%) were incidental carcinomas and 9/66 (14%) were associated with aggressive pathologic features. In the aggressive group, lymph node metastasis to the central compartment was present in 8 (12%) cases, extrathyroidal extension in 4 (6%) cases and one (1.5%) patient had a diffuse sclerosing tumor variant. No significant differences in outcome were found between the two groups. GD patients were more likely to have incidental carcinomas (p = 0.035). Adjusting for baseline patient characteristics, GD patients demonstrated an increased likelihood of harbouring a malignancy (odds ratio (OR) = 2.67; 95% confidence interval (CI) 1.00–7.18) compared to controls. Conclusion More than half of patients with GD undergoing thyroidectomy had concurrent thyroid malignancy with aggressive features present in 14% of patients. GD may confer a heightened risk of thyroid cancer; thyroid nodules should therefore be carefully investigated. |
topic |
Graves’ disease Papillary thyroid carcinoma Aggressive carcinoma Matched cohort Outcomes |
url |
http://link.springer.com/article/10.1186/s40463-019-0364-5 |
work_keys_str_mv |
AT euniceyou prevalenceandaggressivenessofpapillarythyroidcarcinomainsurgicallytreatedgravesdiseasepatientsaretrospectivematchedcohortstudy AT marcoamascarella prevalenceandaggressivenessofpapillarythyroidcarcinomainsurgicallytreatedgravesdiseasepatientsaretrospectivematchedcohortstudy AT abraraljassim prevalenceandaggressivenessofpapillarythyroidcarcinomainsurgicallytreatedgravesdiseasepatientsaretrospectivematchedcohortstudy AT veroniqueisabelleforest prevalenceandaggressivenessofpapillarythyroidcarcinomainsurgicallytreatedgravesdiseasepatientsaretrospectivematchedcohortstudy AT michaelphier prevalenceandaggressivenessofpapillarythyroidcarcinomainsurgicallytreatedgravesdiseasepatientsaretrospectivematchedcohortstudy AT michaeltamilia prevalenceandaggressivenessofpapillarythyroidcarcinomainsurgicallytreatedgravesdiseasepatientsaretrospectivematchedcohortstudy AT marcpusztaszeri prevalenceandaggressivenessofpapillarythyroidcarcinomainsurgicallytreatedgravesdiseasepatientsaretrospectivematchedcohortstudy AT richardjpayne prevalenceandaggressivenessofpapillarythyroidcarcinomainsurgicallytreatedgravesdiseasepatientsaretrospectivematchedcohortstudy |
_version_ |
1724519099724201984 |