A diffuse sclerosing variant of XXXX : clinical and pathologic features and outcomes of 34 consecutive cases.

@entity3557 @entity1 @entity2558 @entity146 @entity5
BACKGROUND: The diffuse sclerosing variant of @entity3557 (DSPC) is a relatively rare variant of @entity3557 . Large studies of @entity1 with DSPC have been infrequently performed, and controversy still exists concerning some DSPC features and outcomes. The aim of the present study was to retrospectively evaluate the clinicopathologic features and outcomes in a series of 34 consecutive @entity1 with DSPC and to compare them with a larger group of 245 consecutive @entity1 with the classic variant of @entity3557 (cPTC) that were evaluated in the same period. @entity1 AND METHODS: Clinical and histological features (sex, age, @entity5 size,multifocality, bilaterality, extra thyroid extension, and local and distant metastases) were recorded in all @entity1 , as well as any persistent or recurrent disease and the @entity1 ' disease status at last observation. @entity1 with cPTC were classified as either low (122) or high risk (123). DSPC and high-risk @entity1 were all treated with the same protocol, including       I treatment. All @entity1 were included in a Cox regression model analysis to investigate the effect of each variable on the hazard ratio. RESULTS: As expected, multifocality, bilaterality, and extra thyroid extension were more frequently noted at presentation, and the @entity2558 category of TNM classification was less frequently noted in DSPC and high-risk @entity1 with cPTC compared with low-risk @entity1 with cPTC. No significant difference was found between @entity1 with DSPC and those with high-risk cPTC, except that extra thyroid extension was found more frequently in the @entity1 with DSPC. Using multivariate analysis, diffuse sclerosing variant was an independent variable for predicting a high risk of persistent and recurrent disease during initial follow-up. However, at a later time, and after further treatment, the disease status was not different between @entity1 with DSPC and those with high-risk cPTC, and only the presence of distant metastases affected the final outcome. CONCLUSIONS: DSPC is a @entity3557 variant characterized by high @entity146 . In @entity1 with DSPC, the outcome is worse than in @entity1 with low-risk cPTC; and, at presentation, characteristics are somewhat worse than for @entity1 with high-risk cPTC.At medium term, the outcome is similar to that observed in @entity1 with high-risk cPTC, provided aggressive treatment is used (additional surgical intervention, when required, and/or       I radiotherapy).
