[Papillary microcancer of the thyroid]. / Microcancer papillaire de la thyroïde.

ABSTRACT

The aim of this study was to determine the outcome of patients operated for microscopic papillary cancer of the thyroid. Between 1962 to 1991, among 1103 patients operated for papillary thyroid carcinoma, 115 (11.5%) had a cancer with a diameter of 10 mm or less, no clinically detectable. 48 patients were diagnosed incidentally at the time of operation for other thyroid diseases, and 67 patients presented cervical lymph node metastases as the first sign. For patients diagnosed for other thyroid diseases, unilateral lobectomy with local neck dissection was performed in 35 cases, and in patients with cervical lymph node metastases unilateral lobectomy with locoregional neck dissection was performed in 56 cases. Mean overall follow-up was 12 years, and median follow-up time of 105 surviving patients was 10 years. 10-year survival rates were 100% in the patients diagnosed for other thyroid diseases, and 87% in patients with cervical lymph node metastases (P < 0.05). Out of 48 patients with no cervical lymph nodes, 44 were alive, and 4 died without recurrence or metastases. Out of the 67 patients with cervical lymph nodes, 5 died of the carcinoma. These results suggest that for patients diagnosed for other thyroid diseases, unilateral lobectomy with local neck dissection is sufficient, and for patients with cervical lymph node metastases unilateral lobectomy and locoregional neck dissection is necessary.