SUMMARY OF THE STUDY
There were 131 patients with tall-cell papillary thyroid cancer (73% with <30% and 27% with >30% tall-cell cells) examined in this study and compared to 104 patients with classical papillary thyroid cancer. Compared to the group of patients with classical papillary thyroid cancer, both tall-cell groups had higher rates of “aggressive” features, ie vascular invasion, gross extension of the cancer outside of the thyroid and spread to the lymph nodes in the neck. Patients with classical papillary thyroid cancer had a higher 5-year disease-free survival rate (92.7%) as compared with those with focal tall-cell change (76.3%) and tall-cell variant (62.2%). After taking into account cancer size and other aggressive features, patients with <10% tall-cell features had significantly lower rates of persistent or recurrent disease compared to those with 10-30%, 20-30%, and >30% tall-cell features.
WHAT ARE THE IMPLICATIONS OF THIS STUDY?
Almost all tall-cell featured papillary thyroid cancers are created equal. They all appear to behave the same and have worse outcomes than classical papillary thyroid cancer. A tall-cell proportion of <10% focal changes should be used as the cutoff for predicting outcomes, which can be used to help counsel patients on treatment and prognosis. Those patients with a tall-cell proportion >10% should be targeted for more aggressive therapy and closer monitoring.
— Melanie Goldfarb, MD