Abstract
Objective. To evaluate the prognosis of tall cell variant (TCV) compared to usual variant (UV) papillary thyroid cancer by comparing disease-related mortality and recurrence data from published studies. Methods. Ovid MEDLINE keyword search using “tall cell variant papillary thyroid cancer” was used to identify studies published in English that calculated disease-related mortality and recurrence rates for both TCV and UV. Results. A total of 131 cases of tall cell variant papillary thyroid cancer were reviewed. The combined odds ratio of recurrence for TCV compared to UV is 4.50 with a 95% confidence interval from 2.90 to 6.99. For disease-related mortality, the combined odds ratio for TCV was compared to UV of 14.28 with a 95% confidence interval from 8.01 to 25.46. Conclusion. Currently published data suggests that TCV is a negative prognostic indicator in papillary thyroid cancer and requires aggressive therapy. This meta-analysis provides the largest prognostic data series on TCV in the literature and clearly identifies the need for accurate pathological identification of TCV and its further study as an independent prognostic factor.
Highlights
Tall cell variant papillary thyroid carcinoma (TCV) was first described in 1976 by Hawk and Hazard as an aggressive histological variant of papillary thyroid cancer [1]
Usual variant papillary thyroid cancer describes conventional papillary thyroid carcinoma composed of papillary epithelial cells arranged in papillae with fibrovascular cores without excessive height compared to cell width
More recently reported case series do not show that tall cell variant (TCV) histology adversely affects prognosis [7, 10, 11]
Summary
Tall cell variant papillary thyroid carcinoma (TCV) was first described in 1976 by Hawk and Hazard as an aggressive histological variant of papillary thyroid cancer [1]. More recently reported case series do not show that TCV histology adversely affects prognosis [7, 10, 11] One such large retrospective study concluded the poor prognosis of TCV tumors was not related to histology but to factors such as stage and grade [10]. Another case series found the higher rate of recurrence in TCV was strictly associated with age over 50 [7]. As larger sample sizes are studied, the potential for misclassification bias increases This may lead to erroneous comparisons of recurrence and mortality data between TCV and UV
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