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Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
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Prognostic Parameters in Differentiated Thyroid Carcinomas.

Nicole A Cipriani1

  • 1Department of Pathology, The University of Chicago, 5841 South Maryland Avenue, MC 6101, Chicago, IL 60637, USA.

Surgical Pathology Clinics
|November 2, 2019
PubMed
Summary
This summary is machine-generated.

Pathologists play a crucial role in identifying key prognostic factors for differentiated thyroid carcinoma. Accurate reporting of histologic variants, extrathyroidal extension, angioinvasion, lymph node status, and specific genetic mutations improves patient outcomes.

Keywords:
AngioinvasionBRAF V600EExtranodal extensionExtrathyroidal extensionFollicular thyroid carcinomaPapillary thyroid carcinomaTERT promoterVariants

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Area of Science:

  • Oncology
  • Pathology
  • Endocrinology

Background:

  • Differentiated thyroid carcinomas (DTCs) represent the majority of thyroid malignancies.
  • The American Joint Committee on Cancer (AJCC) staging and American Thyroid Association (ATA) risk stratification systems are vital for predicting patient outcomes.
  • Accurate pathological assessment is essential for effective management of DTCs.

Purpose of the Study:

  • To review critical pathological factors influencing prognosis in differentiated thyroid carcinoma.
  • To highlight features that aid in predicting mortality and recurrence risk.
  • To guide pathologists on essential elements for comprehensive reporting.

Main Methods:

  • Review of key pathological features relevant to DTC prognosis.
  • Identification of specific histologic variants associated with aggressive disease.
  • Analysis of factors including extrathyroidal extension, angioinvasion, and lymph node characteristics.

Main Results:

  • Aggressive histologic variants (tall cell, columnar cell, hobnail) of papillary thyroid carcinoma are significant.
  • Presence and extent of extrathyroidal extension, angioinvasion, and extranodal extension are critical indicators.
  • Lymph node metastasis characteristics (number, level, size) and specific genetic mutations (BRAF V600E, TERT promoter) are important prognostic markers.

Conclusions:

  • Pathological identification and reporting of specific features are paramount for accurate DTC risk stratification.
  • These factors, when meticulously documented, enhance the predictive power of AJCC and ATA systems.
  • Improved pathological reporting leads to more precise patient management and tailored treatment strategies.