{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:59:52Z","timestamp":1791298792661,"version":"4.1.0"},"reference-count":52,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2013,10,1]],"date-time":"2013-10-01T00:00:00Z","timestamp":1380585600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Tall cell variant (TCV) and diffuse sclerosing variant (DSV) of papillary thyroid cancer are aggressive subtypes, for which tumors \u22641\u2009cm have not been exclusively studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The SEER database (1988\u20132009) was used to compare characteristics of TCV \u22641\u2009cm (mTCV) and DSV \u22641\u2009cm (mDSV) with classic papillary thyroid microcarcinoma (mPTC). Survival was analyzed with the Kaplan\u2013Meier method and log-rank test, and risk factors for nodal metastases with chi-square analysis and binary logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There were 97 mTCV, 90 mDSV, and 18,260 mPTC patients. mTCV incidence increased by 79.9% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.153) over the study period, while mDSV incidence decreased by 10.3% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.315). Compared to classic mPTC, mTCV tended to be larger on average (7.1\u2009mm vs. 5.3\u2009mm,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001), with higher rates of multifocality (47.2% vs. 34.0% respectively,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.018) and lymph-node examination (63.9% vs. 39.2% respectively,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001), while in mDSV, nodal metastases were more frequent (57.1% vs. 33.1% respectively,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.007). Both aggressive variants had higher rates of extrathyroidal extension (27.8% mTCV vs. 13.3% mDSV vs. 6.1% mPTC,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001). Aggressive variants also received radioactive iodine more frequently (39.2% mTCV vs. 40.0% mDSV vs. 29.1% mPTC,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001). However, they were not statistically more likely to receive thyroidectomy over lobectomy compared to classic mPTC. There were no significant differences in overall and disease-specific survival between the histologies. In mTCV, after adjustment, extrathyroidal extension was independently associated with size &gt;7\u2009mm (odds ratio (OR) 4.4 [CI 1.5\u201313.6]) and nodal metastasis with multifocality (OR 5.4 [CI 1.3\u201323.4]) and extrathyroidal extension (OR 5.8 [CI 1.3\u201325.4]). No statistically significant predictors of extrathyroidal extension or nodal metastasis in mDSV were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Aggressive variants of mPTC tend to exhibit more aggressive pathologic characteristics than classic mPTC, but survival appears to be similar. Treatment with total thyroidectomy and central lymphadenectomy may be warranted if the diagnosis can be made pre- or intraoperatively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2012.0563","type":"journal-article","created":{"date-parts":[[2013,4,19]],"date-time":"2013-04-19T17:48:31Z","timestamp":1366393711000},"page":"1305-1311","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":70,"title":["Aggressive Variants of Papillary Thyroid Microcarcinoma Are Associated with Extrathyroidal Spread and Lymph-Node Metastases: A Population-Level Analysis"],"prefix":"10.1177","volume":"23","author":[{"given":"Eric J.","family":"Kuo","sequence":"first","affiliation":[{"name":"Yale School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Goffredo","sequence":"additional","affiliation":[{"name":"Milano-Bicocca University","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Sosa","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanziana A.","family":"Roman","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2013,10,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.18.2164"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24416"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.0137"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-009-0359-x"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318230036d"},{"key":"e_1_3_3_7_2","first-page":"90","article-title":"Papillary carcinoma","volume":"2","author":"Vickery AL Jr","year":"1985","unstructured":"Vickery AL Jr, , Carcangiu ML, , Johannessen JV, , Sobrinho-Simoes M. 1985. 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