Poorly differentiated @entity189 of the thyroid with trabecular, insular, and solid patterns: a clinicopathologic study of 183 XXXX .

@entity1 @entity1377 @entity39 @entity5 @entity146 @entity189 @entity259
BACKGROUND: The term poorly differentiated (PD) carcinoma was proposed 20 years ago to define @entity146 , follicular-derived @entity259 with behavior intermediate between follicular/papillary and @entity189 . Among the variable histologic patterns recognized in such @entity5 , trabecular-insular-solid (TIS) areas usually are predominant. Conversely, some authors pointed out that @entity189 are characterized by unequivocal, high-grade histology with atypias, high mitotic counts, and @entity39 rather than by a specific growth pattern. METHODS: The clinicopathologic features of a series of 183 @entity259 with predominant (n = 165 @entity5 ) or focal (n = 18 @entity5 ) TIS growth patterns were studied by univariate and multivariate overall survival analyses and were compared with clinical outcomes. Subgroups included @entity5 with predominant oxyphilic features (n = 66 @entity5 ) and (residual) @entity1377 features (n = 24 @entity5 ). Control groups of papillary (n = 68 @entity5 ), follicular (n = 71 @entity5 ), and anaplastic (n = 35 @entity5 ) @entity189 also were included for overall survival analysis. RESULTS: TIS @entity189 had an intermediate behavior between papillary/follicular and @entity189 (P < 0.0001). Univariate and multivariate statistical analyses demonstrated that age > 45 years (P = 0.007), the presence of @entity39 (P < 0.0001), and a mitotic count > 3 per 10 high-power fields (P = 0.01) were associated with poor outcome. A simplified scoring system based on statistically significant parameters allowed the identification of three prognostic subgroups (P < 0.0001). CONCLUSIONS: PD TIS @entity189 overall followed a more @entity146 course compared with differentiated @entity259 , irrespective of the extent of the TIS component. However, a numeric scoring system applied to specific clinicopathologic parameters further may identify three prognostic categories of @entity1 who have significantly different survival rates at 5 years and 10 years.
