@article{article_1598676, title={Interplay and clinicopathological correlates of tumor size, multifocality and aggressive variants in patients with operated differentiated thyroid carcinoma: A retrospective cohort study}, journal={The European Research Journal}, volume={11}, pages={551–563}, year={2025}, DOI={10.18621/eurj.1598676}, author={Gürlüler, Ercüment and Özen, Ali Vuslat}, keywords={Differentiated thyroid cancer, cancer foci, tumor size, multifocality/bilaterality, aggressive variants}, abstract={<p> <b>Objectives: </b> To investigate the interplay and clinicopathological correlates of tumor size, cancer foci (multifocality/bilaterality), and aggressive variants in patients with operated differentiated thyroid cancer (DTC). </p> <p> <b>Methods: </b> A total of 596 patients with operated DTC (median age: 47.0 (range: 18.0-87.0 years, 77.5% were females) were included in this retrospective cohort study. Data on patient demographics, cancer foci, concomitant Hashimoto’s thyroiditis, surgery type, DTC subtype (papillary thyroid cancer [PTC], follicular thyroid cancer [FTC]) and variants, tumor size, lymph node metastasis, tumor invasion were recorded. </p> <p> <b>Results: </b> PTC aggressive variant (21.9%, P=0.045), extrathyroidal invasion (24.6%, P=0.012), tall cell PTC variant (60.3%, P=0.043), and widely invasive FTC variants (60.0% P=0.002) rates were significantly higher in the bilateral multifocal tumors than in the unifocal and unilateral multifocal tumors. The rates of Hashimoto’s thyroiditis (59.8%, P<0.001) and PTC subtype (99.6%, P<0.001) were significantly higher, while the rates of lymph node metastasis (5.8%, P<0.001), capsule invasion (11.6%, P<0.001), vascular invasion (0.4%, P<0.001) and extrathyroidal invasion (4.5%, P<0.001) were significantly lower in <10 mm than in >10 mm tumors. Presence vs. absence of PTC aggressive variant was associated with significantly higher greatest tumor size (12 mm, P=0.013) and higher rates of multifocal tumor (50.5%, P=0.013) and extrathyroidal invasion (33.0%, P<0.001). </p> <p> <b>Conclusions: </b> Our findings revealed the presence of bilaterality/multifocality and aggressive variants in a considerable proportion of patients with operated DTC, and a multifaceted interplay between bilaterality/multifocality, tumor size, and PTC aggressive variants, in addition to their individual effects on increased risk of tumor invasion, particularly the extrathyroidal invasion. </p>}, number={3}, publisher={Prusa Medical Publishing}