Papillary thyroid carcinoma: does the association with Hashimoto's
               thyroiditis affect the clinicopathological characteristics of the disease?

Girardi, Fábio Muradás; Barra, Marinez Bizarro; Zettler, Cláudio Galleano

doi:10.1016/j.bjorl.2014.04.006

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Brazilian Journal of Otorhinolaryngology

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Original Articles • Braz. j. otorhinolaryngol. 81 (3) • May-Jun 2015 • https://doi.org/10.1016/j.bjorl.2014.04.006 copy

Papillary thyroid carcinoma: does the association with Hashimoto's thyroiditis affect the clinicopathological characteristics of the disease?^☆ ☆ Please cite this article as: Girardi FM, Barra MB, Zettler CG. Papillary thyroid carcinoma: does the association with Hashimoto's thyroiditis affect the clinicopathological characteristics of the disease? Braz J Otorhinolaryngol. 2015;81:283-7. ^☆☆ ☆☆ Institution: Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre, Rio Grande do Sul, RS, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

INTRODUCTION:

Papillary carcinoma is the most common malignant thyroid neoplasm. The effect of the concurrent presence of Hashimoto's thyroiditis and papillary thyroid carcinoma remains controversial.

OBJECTIVE:

To evaluate the association between Hashimoto's thyroiditis and clinicopathological parameters in thyroid papillary carcinoma cases, based on an historical institutional cohort analysis.

METHODS:

Cross-sectional study obtained from a historical cohort, including all cases submitted to thyroidectomy for papillary thyroid carcinoma in a single institution during an 11-year period study.

RESULTS:

A total of 417 patients with papillary thyroid carcinoma were enrolled; 148 (35.4%) also had Hashimoto's thyroiditis. A female predominance among cases associated to Hashimoto's thyroiditis was observed. The thyroid tumor, in cases associated with Hashimoto's thyroiditis, had a smaller mean diameter, lower frequency of extra-thyroid extension, and earlier clinicopathological staging.

CONCLUSIONS:

A high proportion of papillary thyroid carcinoma cases are associated with Hashimoto's thyroiditis. There are associations among these cases with several histopathological factors already recognized for their prognostic value, which by themselves could impact outcomes.

Thyroid neoplasms; Prognosis; Papillary carcinoma

	Hashimoto thyroiditis
	Present		Absent		Total		p-Value
	Mean (SD)		Mean (SD)		Mean (SD)
Age (years)	45.97 (14.10)		47.15 (14.14)		46.73 (14.12)		0.418
Tumor diameter (cm)	1.40 (1.15)		1.91 (1.70)		1.73 (1.54)		–
	Median (Min–Max)		Median (Min–Max)		Median (Min–Max)		p-Value
Tumor diameter	1.2 (0.04–6.5)		1.3 (0.1–9)		1.2 (0.04–9)		0.007
	n (148)	% (35.4)	n (269)	% (64.5)	n (417)	% (100)	p-Value
Women/men	136/12	91.8/8.1	203/66	75.4/24.5	339/78	81.2/18.7	<0.001
Neurovascular invasion	9	6.0	18	6.6	27	6.4	0.972
Multifocality	32	21.6	53	19.7	85	20.3	0.735
Multicentricity	54	36.4	78	28.9	132	31.6	0.143
Extracapsular invasion	33	22.2	96	35.6	129	30.9	0.006
Lymphadenectomy	79	53.3	102	37.9	181	43.4	0.003
T stage
1	98	66.2	126	46.8	224	53.7	0.002
2	12	8.1	31	11.5	43	10.3
3	38	25.6	109	40.5	147	35.2
4	0	0	3	1.1	3	0.7

N stage
0 ou X	115	77.7	200	74.3	315	75.5	0.240
1a	23	15.5	37	13.7	60	14.3
1b	10	6.7	32	11.8	42	10.0

M stage
0	148	100	267	99.2	415	99.5	0.755
1	0	0	2	0.7	2	0.4	0.755

Clinicopathological staging
I	119	80.4	181	67.2	300	71.9	0.019
II	5	3.3	10	3.7	15	3.5
III	22	14.8	63	23.4	85	20.3
IV	2	1.3	15	5.5	17	4.0

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

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[1] * Corresponding author. E-mail: fabiomgirardi@gmail.com (F.M. Girardi).