Papillary thyroid microcarcinoma with minimal extrathyroidal extension. Is its course so indolent that it requires a less aggressive treatment?
Rev Clin Esp (Barc)
; 221(3): 131-138, 2021 Mar.
Article
in En
| MEDLINE
| ID: mdl-33998460
ABSTRACT
BACKGROUND:
Although the incidence of papillary thyroid microcarcinoma (PTMC) has increased in recent decades, the role played by minimal extrathyroidal extension (mETE) in the prognosis of PTMC is still unclear. The aim of this study is to analyze the factors associated with PTMC with mETE and its long-term prognosis. MATERIAL ANDMETHODS:
We conducted a retrospective study on patients with a histological diagnosis of PTMC. We excluded patients who had previously undergone thyroid surgery, those who had other synchronous malignancies, those with an ectopic location of the PTMC, and those lost to follow-up within two years. We compared group 1 (PTMC without extrathyroidal extension) to group 2 (PTMC with mETE) and performed a multivariate analysis.RESULTS:
We observed PTMC with mETE in 11.2% (nâ¯=â¯18) of patients. On the multivariate analysis, mETE was associated with an age ≥45 years (OR 4.383; 95% CI 1.051-18.283, pâ¯=â¯.043), tumor size ≥8â¯mm (OR 5.913; 95% CI 1.795-19.481; pâ¯=â¯.003), bilaterality (OR 4.430; 95% CI 1.294-15.173; pâ¯=â¯.018) and metastatic lymph nodes (OR 12.588; 95% CI 2.919-54.280; pâ¯=â¯.001). Over the mean follow-up period of 119.8⯱â¯65 months, one case of recurrence was detected in group 2 (0% vs. 5.6%; pâ¯=â¯.112). No patients died of the disease. Disease-free survival was lower in group 2 (124.9⯱â¯5.6 vs. 97.4⯱â¯10.3 months; pâ¯=â¯.034).CONCLUSIONS:
The mETE of PTMC is a factor of worse prognosis associated with the presence of metastatic lymph nodes and a lower rate of disease-free survival.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Thyroid Neoplasms
/
Carcinoma, Papillary
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
/
Middle aged
Language:
En
Journal:
Rev Clin Esp (Barc)
Year:
2021
Document type:
Article