Hürthle cell carcinoma of the thyroid: Retrospective review of 62 patients treated at the Royal Marsden Hospital between 1946 and 2003.

INTRODUCTION: Previous studies have included Hürthle cell carcinoma (HCC) as a variant of follicular thyroid carcinoma in analysis of clinical outcome and others have failed to adequately distinguish between benign and malignant Hürthle cell neoplasms. The aim of this study was to report our experience of histologically confirmed malignant HCC, identifying patient, tumour and treatment factors that predict outcome.

METHODS: A retrospective review was undertaken of all patients treated with HCC between 1946 and 2003. Study end-points were disease-free survival (DFS) and cause-specific survival (CSS). Demographic, pathological and treatment-related factors were all correlated with the study end-points.

RESULTS: Sixty-two patients were followed up for a median (range) of 58 months (2-629). On multivariate analysis, only extent of surgery (p<0.001) was an independent factor affecting CSS. Lymph node status (p=0.008), presence of metastases at diagnosis (p=0.005) and tumour stage (p=0.009) were independent predictors of DFS.

CONCLUSIONS: HCC appears to be a separate entity from follicular thyroid carcinoma (FTC), with a more aggressive disease profile. Lymph node status, tumour stage, and the presence of metastases are independent predictors of DFS. Radical surgery may improve outcome in HCC.