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Master Thesis

Cancer folliculaire oncocytaire de la thyroïde : revue d'une littérature controversée, prédiction du risque métastatique et de la survie dans une série multicentrique de 276 patients du réseau Tuthyref

Abstract : Context : Oncocytic follicular thyroid cancer (Hürthle cell cancer, HCC) is a rare type of follicularpatterned differentiated thyroid cancer. Notably, HCC is considered by the WHO's classification system as an oxyphilic variant of FTC. The clinical outcome of HCC is somewhat controversial in the literature, as it is alternatively described as worse, better or similar than that of the conventional FTC. Patients and methods : Literature review and retrospective multicentric study from the TUTHYREF network, including 276 patients (8-year median follow-up). Results : According to our review, the clinical and biological features of HCC are different from those of FTC: the age at diagnosis is more advanced and it may be more frequent in men. In addition, genomic mutations and expression profiles seem to be different. The expression of sodium-iodide symporter is lower in HCC, which explains its well-known feature of low iodine uptake capability, even in case of well differentiated lesions. Notably, contrarily to some findings in the literature, the frequency of lymph-node and distant metastases (but not the organs involved), as well as the recurrence and survival rates, are similar between HCC and FTC. In our analysis of 276 patients, prognostic factors independently associated to the prognosis were: first, the presence of metastases at diagnosis; then, invasion of the tumor capsule, and finally extrathyroidal extension. In addition, our patients had a higher rate of extra-osseous and extrapulmonary metastases, which is rare in FTC patients. Conclusion : Our results underscore the higher prognostic importance of histopathologic over demographics features (as the age). Moreover our results highlight some HCC singularities. The current 2009 AJCC TNM staging system may not be suitable for HCC prognostic classification.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01167225
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, June 24, 2015 - 9:54:23 AM
Last modification on : Wednesday, August 23, 2017 - 4:40:12 PM
Long-term archiving on: : Tuesday, September 15, 2015 - 10:36:05 PM

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  • HAL Id : dumas-01167225, version 1

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Alexandre-Xavier Boisson. Cancer folliculaire oncocytaire de la thyroïde : revue d'une littérature controversée, prédiction du risque métastatique et de la survie dans une série multicentrique de 276 patients du réseau Tuthyref. Médecine humaine et pathologie. 2015. ⟨dumas-01167225⟩

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