Coexistent Hashimoto's thyroiditis with papillary thyroid carcinoma: Impact on presentation, management, and outcome Journal Article

  

Authors:	Singh, B.; Shaha, A. R.; Trivedi, H.; Carew, J. F.; Poluri, A.; Shah, J. P.
Article Title:	Coexistent Hashimoto's thyroiditis with papillary thyroid carcinoma: Impact on presentation, management, and outcome
Abstract:	Background. This study was performed to assess the relationship between Hashimoto's thyroiditis and the development, presentation, management, and outcome of papillary thyroid carcinoma. Methods. Two complementary analytic methods were used. The clinical study was a retrospective case-control study, including patients seen with papillary thyroid carcinoma presenting during a 12-year period. We also used a systematic literature review to identify suitable reports and meta-analysis to statistically combine published results. Results. The prevalence of Hashimoto's thyroiditis is significantly higher in patients with papillary thyroid cancer (odds ratio, 1.89; 95% CI, 1.02-3.50). These patients typically have a dominant nodule, 44% of which are discovered incidentally on routine examinations. Fine-needle aspiration has a sensitivity of 91% for the identification of papillary cancer. The prognostic variables at the time of a diagnosis of papillary cancer and the approach to management are not altered by the presence of coexistent Hashimoto's thyroiditis. In addition, the rate of surgical complications was not higher in patients with coexistent Hashimoto's disease. Meta-analysis suggested a positive correlation between Hashimoto's disease and disease-free survival (r = 0.09; 95% CI, 0.05-0.12) and overall survival (r = 0.11; 95% CI 0.07-0.15). Conclusions. There is an increased prevalence of Hashimoto's thyroiditis in patients with papillary thyroid carcinoma. The presence of coexistent Hashimoto's thyroiditis does not affect the diagnostic evaluation or management of papillary thyroid cancers. The survival of patients who have papillary thyroid cancers may be superior in coexistent Hashimoto's thyroiditis.
Keywords:	adult; treatment outcome; survival analysis; survival rate; retrospective studies; case-control studies; treatment planning; disease association; prevalence; carcinoma, papillary; high risk patient; thyroid carcinoma; thyroid neoplasms; papillary carcinoma; hashimoto disease; humans; human; male; female; priority journal; article; thyroiditis, autoimmune
Journal Title:	Surgery
Volume:	126
Issue:	6
ISSN:	0039-6060
Publisher:	Elsevier Inc.
Date Published:	1999-12-01
Start Page:	1070
End Page:	1077
Language:	English
DOI:	10.1067/msy.2099.101431
PUBMED:	10598190
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-0032733287&partnerID=40&md5=cc58cbc958f713c099df98cef11cd020
Notes:	Article -- Export Date: 16 August 2016 -- Source: Scopus

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