| Dr Ian D. Hay from the Mayo Clinic, Rochester, MN, USA, received the Paul Starr Lecture for long-term important work in clinical thyroidology. He is an expert in thyroid carcinoma and reviewed several aspects of malignant thyroid disease. He analyzed results in 2278 patients with differentiated thyroid carcinoma, accumulated since 1940 in the Mayo Clinic. Eighty-one percent had papillary carcinoma, 8% medullary carcinoma, 7% follicular carcinoma, and 4% oxyphilic (Hürtle) cell carcinoma. With regard to oxyphilic carcinoma he concluded that this is probably a separate entity. Oxyphilic papillary carcinoma has a worse prognosis than non-oxyphilic papillary carcinoma. In the case of follicular carcinoma the oxyphilic variant has the same prognosis as the non-oxyphilic variant. Oxyphilic papillary carcinoma are rare, and 60% shows aneuploidy in contrast to 10% of non-oxyphilic papillary carcinoma. With regard to papillary carcinoma in general he concluded that the presence of lymphnode metastases bears no prognostic significance. He also introduced a new index to assess the prognosis of papillary carcinoma, based on the presence of distant metastases, age of the patient, completeness of surgery, invasiveness of the tumor, and tumor size. |
