Patterns in the Reporting of Aggressive Histologic Subtypes in Papillary Thyroid Cancer

Yeon J Lee ¹, Caitlin E Egan ¹, Jacques A Greenberg ¹

⁰Department of Surgery, Weill Cornell Medicine, New York, New York.

The Journal of Surgical Research +

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April 24, 2024

View abstract on PubMed

Summary

Aggressive papillary thyroid cancer (PTC) subtypes are linked to poorer outcomes. Reporting varies by facility type and region, suggesting potential geographic or diagnostic factors influencing diagnosis.

Area Of Science

Oncology
Pathology
Epidemiology

Background

Papillary thyroid cancer (PTC) has aggressive subtypes like tall cell, columnar, and diffuse sclerosing.
These aggressive subtypes (aPTC) are increasing in incidence but show wide reporting variations.
Understanding reporting factors and outcomes for aPTC compared to classic PTC (cPTC) is crucial.

Purpose Of The Study

To identify and compare factors associated with reporting aggressive PTC subtypes (aPTC) versus classic PTC (cPTC).
To secondarily investigate differences in patient outcomes between aPTC and cPTC.

Main Methods

Utilized the National Cancer Database (2004-2017) to identify cPTC and aPTC cases.
Analyzed patient demographics, facility characteristics, and clinicopathologic variables.
Performed survival analysis to compare outcomes and identified predictors of aPTC reporting.

Main Results

Academic facilities were more likely to report aPTC than other facility types (1.4-2.0 times).
The Middle Atlantic region reported more aPTC cases compared to other regions, despite regional variations in total facility numbers.
Aggressive PTC subtypes demonstrated higher rates of aggressive features and worse 5-year overall survival (90.5%) compared to classic PTC (94.5%).

Conclusions

Aggressive PTC subtypes are associated with significantly worse patient outcomes.
Reporting of aPTC is more prevalent in academic facilities and the Middle Atlantic region.
Findings suggest a need to explore environmental/geographic factors and improve diagnostic awareness for aPTC.

Keywords:

Aggressive histology Columnar Histology Regional variation Sclerosing