Abstract
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Objectives The descriptive term oxyphilic variant of DTC has not conclusively been investigated. Oxyphilic( =oncocytic) follicular carcinoma (syn. Huerthle Cell Carcinoma HCC) is commonly connotated with slightly poorer prognosis and putative lack of radioiodine uptake. This study reviewed 135 patients with oxyphilic follicular or papillary carcinoma that were treated by radioiodine ablation in our department between 1998 and 2011 with regards to initial staging of extent and invasiveness.
Methods Patients with oxyphilic follicular carcinoma (n=90) and oxyphilic papillary carcinoma (n=45) were included. Patients with other variants of DTC (tall cell etc.) and poorly differentiated TC were excluded. All pts had undergone total thyroidectomy, in 96 pts (71%) lymphadenectomy had been performed on. A patient cohort with non-oxyphilic DTC (n= 930: PTC n= 795; FTC n=135) treated in our department was used for comparison. Age at diagnose, gender, tumor size and multifocality, lymph node and distant metastases at initial diagnose were assessed.
Results Patients with oxyphilic variants proved to be significantly older than pts with PTC (58 yr vs. 50 yr; p<0.05), whereas gender distribution was similar. Oxyphilic tumors were more often multifocal and larger than FTC. Rates of lymphatic and distant metastases at diagnose were similar to those of FTC rather than PTC (lymph node metastases oxyphilic group 10% vs. 20% PTC and 8% FTC; distant met oxyphilic group 9% vs. 1% PTC and 18% FTC).
Conclusions This study suggests on one of the largest datasets of patients with oxyphilic tumors that these variants of FTC and PTC do not differ significantly from each other but have initial features that are more similar to non-oxyphilic FTC patients. Ongoing evaluation is indicating less radioiodine uptake in persistant metastases of patients with oxyphilic variants of DTC than in non-oxyphilic DTC.