Factores de riesgo y supervivencia en el carcinoma de células de Hürthle. Revisión sistemática y metanálisis

Abstract

Background: Hurthle cell carcinoma (HCC) of the thyroid gland, which accounts for about 0.4–10% of all differentiated thyroid cancer, is considered differentiated carcinoma with a distinct entity. The treatment of this disease is controversial since there are no prospective randomized controlled trials validating the extent of thyroidectomy and the efficacy of adjuvant treatment with radioactive iodine or radiation therapy.Objective: The aim of this study is to analyze the prognostic factors affecting survival of patients with HCC.Material and methods: We performed an electronic search in MEDLINE, EMBASE, COCHRANE, and LILACS-BIREME databases to find relevant literature regarding risk and prognostic factors affecting survival.Results: Male sex, tumor size > 4 cm, lymph node involvement, extrathyroid extension and distantmetastases were associated with adverse outcome. Total thyroidectomy showed a trend toward higher survival.Conclusions: The management of patients with HCC is still controversial. Large-scale research on multimodal treatments is required. The AACCyC national registry which is opened to all surgeons will provide high quality evidence on the matter. The authors are aware of the strengths and weaknesses of this presentation. This is the first meta-analysis on risk factors and survival of HCC; however, the degree of heterogeneity of the studies was very high for some variables and it was not possible to include in this analysis other risk factors that could affect the prognosis. .