Surgery consisted of removal of the whole thyroid gland (total thyroidectomy) as well as removal of the central and lateral lymph nodes in the neck. This was followed by radioactive iodine therapy. The diagnosis was confirmed by experts. These patients were followed up yearly for 7 years. The characteristics of these patients were then compared to 2945 patients with thyroid cancer that was not the diffuse sclerosing variant and 48 high-risk papillary thyroid cancer patients treated during the same time period.
When patients with diffuse sclerosing variant were compared to the patients with non-diffuse sclerosing variant thyroid cancer, they were found to have multiple cancers within the thyroid, larger cancer, more lymph nodes involved with cancer, more frequent extension of cancer beyond the thyroid gland, more invasion of the cancer into blood vessels and higher rates of recurrence (i.e., the cancer coming back). When patients with diffuse sclerosing variant were compared to the patients with other high-risk papillary thyroid cancer, they were found to have more extensive disease with the same recurrence risk but overall lower death rates.
WHAT ARE THE IMPLICATIONS OF THIS STUDY?
This study has implications for patients and physicians. Patients diagnosed with the diffuse sclerosing variant of papillary thyroid cancer present with aggressive features and high rates of extensive disease. The risk of recurrence is similar to other high-risk papillary thyroid cancers, despite extensive initial surgery and radioactive iodine ablation. Therefore, these patients should be carefully followed-up as they are more likely to require additional surgery in the future for local recurrence.
— Maria Papaleontiou, MD
ATA THYROID BROCHURE LINKS
Thyroid Cancer (Papillary and Follicular): http://www. thyroid.org/thyroid-cancer/
Radioactive Iodine: http://www.thyroid.org/ radioactive-iodine/
Thyroid Surgery: http://www.thyroid.org/thyroid-surgery/