Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Konkret geht es um den Diabetes-Patienten mit kardiovaskulären Erkrankungen oder Risiken, die Herzinsuffizienz sowie die kardiovaskuläre Primär- und Sekundärprävention. Sind Sie hier schon auf dem neuesten Stand? Unsere Experten beleuchten, wo und warum das bisherige Procedere geändert werden soll und was in der Praxis sinnvoll ist. Holen Sie sich Ihr Update und 2 CME-Punkte beim MMW-Webinar am 24. April von 17.30 bis 19 Uhr. 
Erweiterte Suche
Anmelden
nach oben
World Journal of Surgery
Erschienen in: World Journal of Surgery 5/2007

01.05.2007

An evidence-based review of poorly differentiated thyroid cancer

verfasst von: Enoch M. Sanders Jr., Virginia A. LiVolsi, James Brierley, Jennifer Shin, Gregory W. Randolph

Erschienen in: World Journal of Surgery | Ausgabe 5/2007

Einloggen, um Zugang zu erhalten

Abstract

Background

Poorly differentiated thyroid cancer (PDTC) presents the endocrinologist and surgeon with challenges of recognition and treatment given the lack of consensus on histopathologic definition and limited literature on surgical and nonsurgical treatment.

Methods

We offer an operational pathologic definition for PDTC, which should help guide future work in this area. Poorly differentiated thyroid cancer should include insular and trabecular variants but should not include solid type lesions (included by other workers) or more differentiated tumors that may have poor prognosis such as tall cell, columnar, diffuse sclerosing, and oncocytic lesions. Systematic evidence-based literature reviews focusing on two questions were carried out: (1) is PDTC associated with an intermediate prognosis relative to anaplastic and WDTC? and (2) What are the postoperative treatment options for poorly differentiated thyroid cancer?

Conclusions

We have found level IV evidence that PDTC is intermediate between WDTC and anaplastic cancers in terms of prognosis. It represents a disease where appropriate administration of aggressive treatment not typically necessary for routine WDTC and not effective for anaplastic disease may uniquely result in substantial benefit. Limited level IV data show conflicting results regarding 131I treatment benefit. Given lack of morbidity and potential for benefit, we recommend that 131I therapy be considered in all patients postoperatively. Recommendation regarding external beam radiotherapy (XRT) is based primarily on extrapolation from studies in forms of poor-prognosis WDTC where substantial data exist regarding treatment benefit. We recommend that external beam treatment be considered in all patients with PDTC with T3 tumors without distant metastasis, all patients with T4 tumors, and all patients with regional lymph node involvement.
Literatur
1.
Akslen LA, LiVolsi VA (2000) Prognostic significance of histologic grading compared with subclassification of papillary thyroid carcinoma. Cancer 88:1902–1908CrossRefPubMed
2.
Akslen LA, LiVolsi VA (2000) Poorly differentiated thyroid carcinoma—it is important. Am J Surg Pathol 24:310–313CrossRefPubMed
3.
Sakamoto A, Kasai N, Sugano H (1983) Poorly differentiated carcinoma of the thyroid. A clinicopathologic entity for a high-risk group of papillary and follicular carcinomas. Cancer 52:1849–1855CrossRefPubMed
4.
Nishida T, Katayama S, Tsujimoto M, et al. (1999) Clinicopathological significance of poorly differentiated thyroid carcinoma. Am J Surg Pathol 23:205–211CrossRefPubMed
5.
Sakamoto A (2004) Definition of poorly differentiated carcinoma of the thyroid: the Japanese experience. Endocr Pathol 15:307–311CrossRefPubMed
6.
Collini P, Mattavelli F, Pellegrinelli A, et al. (2006) Papillary carcinoma of the thyroid gland of childhood and adolescence: morphologic subtypes, biologic behaviour and prognosis. Am J Surg Pathol 30:1420–1426CrossRefPubMed
7.
Rosai J, Carcangiu ML, DeLellis RD (1992) Tumors of the Thyroid Gland. AFIP fascicle series 3, no.4. Armed Forces Institute of Pathology, Washington, DC
8.
Sobrinho-Simoes M, Nesland JM, Johannessen JV (1988) Columnar-cell carcinoma. Another variant of poorly differentiated carcinoma of the thyroid. Am J Clin Pathol 89:264–267PubMed
9.
Carcangiu ML, Zampi G, Rosai J (1984) Poorly differentiated (“insular” thyroid carcinoma. Am J Surg Pathol 8:655–668CrossRefPubMed
10.
Guiter GE, Auger M Ali SZ, et al. (1999) Cytopathology of insular carcinoma of the thyroid. Cancer 87:196–202CrossRefPubMed
11.
Leong JL, Yuen HW, LiVolsi VA, et al. (2004) Insular carcinoma of the thyroid with jugular vein invasion. Head Neck 26:642–646CrossRefPubMed
12.
Nikiforov YE, Gnepp DR (1994) Pediatric thyroid cancer after the Chernobyl disaster. Pathomorphologic study of 84 cases (1991–992) from the Republic of Belarus. Cancer 74:748–766CrossRefPubMed
13.
Tronko MD, Bogdanova TI, Komissarenko IV, et al. (1999) Thyroid carcinoma in children and adolescents in Ukraine after the Chernobyl nuclear accident: statistical data and clinicomorphologic characteristics. Cancer 86:149–156CrossRefPubMed
14.
Harach R, Williams ED (1995) Childhood thyroid cancer in England and Wales. Br J Cancer 72:777–783PubMed
15.
Williams ED, Abrosimov A, Bogdanova T, et al. (2004) Thyroid carcinoma after Chernobyl: latent period, morphology and aggressiveness. Br J Cancer 90:2219–2224PubMed
16.
Nikiforov YE, Erickson LE, Nikiforova MN, et al. (2001) Solid variant of papillary thyroid carcinoma: incidence, clinical-pathological characteristics, molecular analysis, and biological behavior. Am J Surg Pathol 25:1478–1484CrossRefPubMed
17.
Volante M, Collini P, Nikiforov, Y, et al. (2007) Poorly differentiated thyroid carcinoma: the Turin proposal for the use of uniform diagnostic criteria and an algorithmic diagnostic approach. Am J Surg Pathol in press
18.
Papotti M, Botto Micca F, Favero A, et al. (1993) Poorly differentiated thyroid carcinomas with primordial cell component. A group of aggressive lesions sharing insular, trabecular, and solid patterns. Am J Surg Pathol 17:291–301CrossRefPubMed
19.
Pilotti S, Collini P, Manzari A, et al. (1995) Poorly differentiated forms of papillary thyroid carcinoma: distinctive entities or morphological patterns? Semin Diagn Pathol 12:249–255PubMed
20.
Pilotti S, Collini P, Mariani L, et al. (1997) Insular carcinoma: a distinct de novo entity among follicular carcinomas of the thyroid gland. Am J Surg Pathol 21:1466–1473CrossRefPubMed
21.
Sobrinho-Simoes M, Sambade C, Fonseca E, et al. (2002) Poorly differentiated carcinomas of the thyroid gland: a review of the clinicopathologic features of a series of 28 cases of a heterogeneous, clinically aggressive group of thyroid tumors. Int J Surg Pathol 10:123–131CrossRefPubMed
22.
Volante M, Landolfi S, Chiusa L, et al. (2004) Poorly differentiated carcinomas of the thyroid with trabecular, insular and solid patterns. A clinico-pathological study of 183 cases. Cancer 100:950–957CrossRefPubMed
23.
Volante M, Cavallo GP, Papotti M (2004) Prognostic factors of clinical interest in poorly differentiated carcinomas of the thyroid. Endocr Pathol 15:313–317CrossRefPubMed
24.
Hiltzik D, Carlson DL, Tuttle RM, et al. (2006) Poorly differentiated thyroid carcinomas defined on the basis of mitosis and necrosis: a clinicopathologic study of 58 patients. Cancer 106:1286–1295CrossRefPubMed
25.
Ljungberg O, Bondeson L, Bondeson AG (1984) Differentiated thyroid carcinoma, intermediate type: a new tumor entity with features of follicular and parafollicular cell carcinoma. Hum Pathol 15:218–228CrossRefPubMed
26.
Soares P, Trovisco V, Rocha AS, et al. (2004) BRAF mutations typical of papillary thyroid carcinoma are more frequently detected in undifferentiated than in insular and insular-like poorly differentiated carcinomas. Virchows Arch 444:572–576CrossRefPubMed
27.
Hosel SA, Apel RL, Freeman J, et al. (1997) Immunohistochemical localization of p53 in human thyroid neoplasms: correlation with biological behavior. Endocr Pathol 8:21–28CrossRef
28.
Nikiforov YE (2004) Genetic alterations involved in the transition from well-differentiated to poorly differentiated and anaplastic thyroid carcinomas. Endocr Pathol 15:319–327CrossRefPubMed
29.
Nikiforova MN, Kimura ET, Gandhi M, et al. (2003) BRAF mutations in thyroid tumors are restricted to papillary carcinomas and anaplastic or poorly differentiated carcinomas arising from papillary carcinomas. J Clin Endocrinol Metab 88:5399–404CrossRefPubMed
30.
Santoro M, Papotti M, Chiappetta G, et al. (2002) RET activation and clinicopathologic features in poorly differentiated thyroid tumors. J Clin Endocrinol Metab 87:370–379CrossRefPubMed
31.
Sackett DL (1989) Rules of evidence and clinical recommendations on the use of antithrombotic agents. Chest 95:2S–4SPubMed
32.
Wreesman V, Ghossein R (2002) Genome-wide appraisal of thyroid cancer progression. Am J Pathol 161:1549–1556
33.
Luna-Ortiz K, Hurtado-López LM, Domínguez-Malagón H, et al. (2004) Clinical course of insular thyroid carcinoma. Med Sci Monit 10:cr108–111PubMed
34.
Brierley J, Tsang R, Panzarella T, et al. (2005) Prognostic factors and the effect of treatment with radioactive iodine and external beam radiation on patients with differentiated thyroid cancer seen at a single institution over 40 years. Clin Endocrinol (Oxf) 63:418–427CrossRef
35.
Vassilopoulou-Sellin R, Schultz PN, Haynie TP (1996) Clinical outcome of patients with papillary thyroid carcinoma who have recurrence after initial radioactive iodine therapy. Cancer 78:493–501CrossRefPubMed
36.
Pellegriti G, Giuffrida D, Scollo C, et al. (2002) Long-term outcome of patients with insular carcinoma of the thyroid: the insular histotype is an independent predictor of poor prognosis. Cancer 95:2076–2085CrossRefPubMed
37.
Tsang RW, Brierley JD, Simpson WJ, et al. (1998) The effects of surgery, radioiodine and external radiation therapy on the clinical outcome of patients with differentiated thyroid cancer. Cancer 82:375–388CrossRefPubMed
38.
Chow S-M, Law SCK, Mendenhall WM, et al. (2002) Papillary thyroid carcinoma: prognostic factors and the role of radioiodine and external radiotherapy. Int J Radiat Oncol Biol Physics 52:784–795CrossRef
39.
Esik O, Nemeth G, Eller J (1994) Prophylactic external irradiation in differentiated thyroid cancer: a retrospective study over a 30-year observation period. Oncology 51:372–379CrossRefPubMed
40.
Ford D, Giridharan S, McConkey C, et al. (2003) External beam radiotherapy in the management of differentiated thyroid cancer. Clin Oncol (R Coll Radiol) 15:337–341
41.
Kim TH, Yang DS, Jung KY, et al. (2003) Value of external irradiation for locally advanced papillary thyroid cancer. Int J Radiat Oncol Biol Phys 55:1006–1012CrossRefPubMed
42.
Phlips P, Hanzen C, Andry G, et al. (1993) Postoperative irradiation for thyroid cancer. Eur J Surg Oncol 19:399–404PubMed
43.
Tubiana M, Haddad E, Schlumberger M, et al. (1985) External radiotherapy in thyroid cancers. Cancer 55:2062–2071CrossRefPubMed
44.
Farahati J, Reiners C, Stuschke M, et al. (1996) Differentiated thyroid cancer. Impact of adjuvant external radiotherapy in patients with perithyroidal tumor infiltration (stage pT4). Cancer 77:172–180CrossRefPubMed
45.
Chao TC, Lin JD, Chen MF (2004) Insular carcinoma: infrequent subtype of thyroid cancer with aggressive clinical course. World J Surg 28:393–396CrossRefPubMed
46.
Glanzmann C, Lutolf UM (1992) Long-term follow-up of 92 patients with locally advanced follicular or papillary thyroid cancer after combined treatment. Strahlenther Onkol 168:260–269PubMed
47.
O’Connell M, RP AH, Harmer CL (1994) Results of external beam radiotherapy in differentiated thyroid carcinoma: a retrospective study from the Royal Marsden Hospital. Eur J Cancer 30A:733–739
48.
Harmer C, Bidmead M, Shepherd S, et al. (1998) Radiotherapy planning techniques for thyroid cancer. Br J Radiol 71:1069–1075PubMed
49.
Nutting CM, Convery DJ, Cosgrove VP, et al. (2001) Improvements in target coverage and reduced spinal cord irradiation using intensity-modulated radiotherapy (IMRT) in patients with carcinoma of the thyroid gland. Radiother Oncol 60:173–180CrossRefPubMed
50.
Rosenbluth BD, Serrano V, Happersett L, et al. (2005) Intensity-modulated radiation therapy for the treatment of nonanaplastic thyroid cancer. Int J Radiat Oncol Biol Phys 63:1419–1426CrossRefPubMed
51.
Auersperg M, Us-Krasovec M, Petric G, et al. (1990) Results of combined modality treatment in poorly differentiated and anaplastic thyroid carcinoma. Wien Klin Wochenschr 27:267–270
52.
Justin EP, Seabold JE, Robinson RA, et al. (1991) Insular carcinoma: a distinct thyroid carcinoma with associated iodine-131 localization. J Nucl Med 32:1358–1363PubMed
53.
Lai HW, Lee CH, Chen JY, et al. (2006) Insular thyroid carcinoma: collective analysis of clinicohistologic prognostic factors and treatment effect with radioiodine or radiation therapy. J Am Coll Surg 203:715–722CrossRefPubMed
54.
Randolph GW, Kamani D (2006) The importance of preoperative laryngoscopy in patients undergoing thyroidectomy. Surgery 139:317CrossRef
55.
McCaffrey TV, Burgstrahl EJ, Hay ID, et al. (1994) Locally invasive papillary carcinoma 1940–1990. Head Neck 16:165CrossRefPubMed
56.
McConahey WM Hay ID, Woolner LB, et al. (1986) Papillary thyroid cancer treated at the Mayo Clinic 1946 through 1970: initial manifestations, pathologic findings, therapy and outcome. Mayo Clinic Proc 61:978
57.
Tollefson H, DeCosse J, Hutter R (1964) Papillary carcinoma of the thyroid: a clinical and pathological study of 70 fatal cases. Cancer 17:1035CrossRef
Metadaten
Titel
An evidence-based review of poorly differentiated thyroid cancer
verfasst von
Enoch M. Sanders Jr.
Virginia A. LiVolsi
James Brierley
Jennifer Shin
Gregory W. Randolph
Publikationsdatum
01.05.2007
Verlag
Springer-Verlag
Erschienen in
World Journal of Surgery / Ausgabe 5/2007
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-007-9033-3

Weitere Artikel der Ausgabe 5/2007

World Journal of Surgery 5/2007 Zur Ausgabe

OriginalPaper

Comparison of Outcomes Following Ileostomy versus Colostomy for Defunctioning Colorectal Anastomoses

OriginalPaper

Telomerase Activity in Tumor and Remnant Liver as Predictor of Recurrence and Survival in Hepatocellular Carcinoma after Resection

OriginalPaper

Lateral and Mediastinal Lymph Node Dissection in Differentiated Thyroid Carcinoma: Indications, Benefits, and Risks

OriginalPaper

An Evidence-Based Approach to the Treatment of Thyroid Lymphoma

OriginalPaper

Genotype-Phenotype Based Surgical Concept of Hereditary Medullary Thyroid Carcinoma

OriginalPaper

An Evidence-based Approach to Familial Nonmedullary Thyroid Cancer: Screening, Clinical Management, and Follow-up

Neu im Fachgebiet Chirurgie

23.04.2024 | Ablationstherapie | Nachrichten

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 | Appendizitis | Nachrichten

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 | Operationsvorbereitung | Nachrichten

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

19.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Ureterstriktur: Innovative OP-Technik bewährt sich
weitere anzeigen

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.