ESMO Congress 2023 | OncologyPRO

Abstract 2216P

Background

Diffuse sclerosing variant of papillary thyroid carcinoma (DSVPTC) is commonly observed in young patients, with a median age at diagnosis in the third decade of life. Further, the risk of recurrence is higher with DSVPTC than with classical papillary thyroid carcinoma (PTC). Therefore, this study aimed to describe the clinicopathological and genetic characteristics of patients of different ages with DSVPTC.

Methods

We retrospectively reviewed 397 patients who underwent thyroidectomy for DSVPTC at the Gangnam Severance Hospital, Yonsei University from January 2005 to December 2017. We selected 41 patients through random sampling by their age group, and examined mutations in 119 genes using next-generation sequencing.

Results

The mean age at diagnosis was 36.7±11.6 years, with the majority of patients (163, 41.1%) in their third decades. DSVPTC was predominant in women (276, 69.5%), compared with men. We observed recurrence in 46 patients (11.6%), with regional nodal recurrence being the most common recurrence site (32 patients, 69.6%). The tumour size increased in younger patients (<20 years: 2.69±1.56, 21–30 years: 1.88±1.30, and 31–40 years: 1.55±0.95), those displaying a plateau in their fourth (1.38±0.85) and fifth (1.29±0.91) decades, and those above 61 years of age (1.63±1.45). The initial presentation of cancer was more aggressive in paediatric patients with a larger size, more common multiplicity, and lateral neck metastasis. V-raf murine sarcoma viral oncogene homolog B1 (BRAF), Kirsten rat sarcoma virus (KRAS), and telomerase reverse transcriptase (TERT) displayed relatively higher mutations, compared with other genes.

Conclusions

DSVPTC displayed different clinical, pathological, and molecular profiles, compared with papillary thyroid carcinoma. BRAF, KRAS, and TERT were the most important genetic mutations, with differences depending on the age.