Hashimoto’s thyroiditis predicts outcome in intrathyroidal papillary thyroid cancer

    1. Antongiulio Faggiano3
    1. 1Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
    2. 2IOS & COLEMAN Srl, Naples, Italy
    3. 3Thyroid and Parathyroid Surgery Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori-IRCCS ‘Fondazione G. Pascale’, Naples, Italy
    4. 4Department of Anesthesiologic, Surgical and Emergency Sciences, Division of General and Oncologic Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
    5. 5Department of Public Health, University of Naples ‘Federico II,’, Naples, Italy
    6. 6San Giovanni di Dio e Ruggi D’Aragona, Universitary Hospital, Division of General Surgery, University of Salerno, Salerno, Italy
    7. 7Department of Pathology, Istituto Nazionale per lo Studio e la Cura dei Tumori-IRCCS ‘Fondazione G. Pascale’, Naples, Italy
    8. 8Dipartimento Chirurgico Generale e Polispecialistico, Chirurgia 2, AORN Cardarelli, Naples, Italy
    9. 9Dipartimento di Scienze Chirurgiche, Università di Roma Sapienza, Roma, Italy
    1. Correspondence should be addressed to V Marotta; Email: vinc.endo{at}libero.it


    Hashimoto’s thyroiditis (HT) seems to have favourable prognostic impact on papillary thyroid cancer (PTC), but data were obtained analysing all disease stages. Given that HT-related microenvironment involves solely the thyroid, we aimed to assess the relationship between HT, as detected through pathological assessment, and outcome in intrathyroidal PTC. This was a multicentre, retrospective, observational study including 301 PTC with no evidence of extrathyroidal disease. Primary study endpoint was the rate of clinical remission. Auxiliary endpoint was recurrence-free survival (RFS). HT was detected in 42.5% of the cohort and was associated to female gender, smaller tumour size, lower rate of aggressive PTC variants and less frequent post-surgery radio-iodine administration. HT showed relationship with significantly higher rate of clinical remission (P < 0.001, OR 4, 95% CI 1.78–8.94). PTCs with concomitant HT had significantly longer RFS, as compared with non-HT tumours (P = 0.004). After adjustment for other parameters affecting disease outcome at univariate analysis (age at diagnosis, histology, tumour size and multifocality), prognostic effect of HT remained significant (P = 0.006, OR 3.28, 95% CI 1.39–7.72). To verify whether HT could optimise the identification of PTCs with unfavourable outcome, we assessed the accuracy of ‘non-HT status’ as negative prognostic marker, demonstrating poor capability of identifying patients not maintaining clinical remission until final follow-up (probability of no clinical remission in PTCs without HT: 21.05%, 95% CI 15.20–27.93). In conclusion, our data show that HT represents an independent prognostic parameter in intrathyroidal PTC, but cannot improve prognostic specificity.

    • Received 5 July 2017
    • Accepted 10 July 2017
    • Made available online as an Accepted Preprint 10 July 2017
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