Similar outcome in patients with Hurthle-cell
carcinoma and follicular carcinoma
(July 2003)
The background of
the study. The clinical and pathologic determinants of prognosis
in patients with Hurthle-cell carcinomas are poorly understood,
and whether their prognosis differs from that of patients with follicular
carcinoma is debated. This retrospective study was done to determine
the features of Hurthle-cell carcinoma and prognosis in a national
cohort of patients, and the results were compared with a matched
group of patients with follicular carcinoma.
Patient Selection and Characteristics.
All cases of Hurthle-cell carcinoma entered in the Surveillance,
Epidemiology and End Results database from 1973 to 1998 were reviewed.
This database contains cancer incidence and survival data from 11
cancer registries throughout the United States. Among 20,025 patients
with thyroid carcinoma recorded in this database during this period,
555 (3 percent) had a Hurthle-cell carcinoma. There were 377 women
(68 percent) and 178 men (32 percent); the average age at diagnosis
was 56 years. The mean tumor size was 3.5 cm; most patients (84
percent) had only thyroid disease, but 16 percent had invasion of
structures in the neck.
The outcome in 411 of the patients with Hurthle-cell carcinoma
was compared with that of 411 patients with follicular carcinoma
of the same age, sex, tumor size, extent of local extension, and
year of diagnosis.
The results of the study. The 10-year
mortality rate was approximately 20 percent in women and 45 percent
in men, and was highest in older men with large tumors. The overall
5- and 10-year mortality rates in the patients with Hurthle-cell
carcinoma were 15 percent and 29 percent, respectively, as compared
with 11 percent and 45 percent, respectively, in the patients with
follicular carcinoma. The mean survival time in the patients with
Hurthle-cell carcinoma was 109 months, as compared with 113 months
in the patients with follicular carcinoma.
The conclusions of the study. Among
patients with Hurthle-cell carcinoma, male sex, older age, large
tumor size, and major extension indicate a poor prognosis. The mortality
rate is similar among patients with Hurthle-cell carcinoma and matched
patients with follicular carcinoma.
The original article. Bhattacharyya
N. Survival and prognosis in Hurthle cell carcinoma of the thyroid
gland. Arch Otolaryngol Head Neck Surg 2003;129:207-10.
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