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Papillary thyroid microcarcinoma (PTMC): prognostic factors, management and outcome in 403 patients
M R Pelizzo1, I M Boschin, A Toniato
1Department of Special Surgery, University of Padova Medical School, Via Giustiniani 2, 35100 Padova, Italy.
Aim:
To investigate an "optimal" therapeutic management of patients with papillary thyroid microcarcinoma (PTMC).
Methods:
We evaluated a group of 403 consecutive patients affected by PTMC operated on by the same surgeon. Prognostic factors were evaluated by uni- and multivariate statistical analysis.
Results:
After a mean follow-up of 8.5 years, 372 patients were living without disease (undetectable serum thyroglobulin levels), 24 patients were living with disease (increased serum thyroglobulin levels), 6 patients were deceased due to causes different from thyroid cancer, and 1 patient was deceased due to metastatic thyroid cancer. No statistically significant prognostic factor was found at uni- and multivariate analysis. However, it is worth noting that in patients with a larger primary tumour (size> or =5mm) and treated by partial thyroidectomy alone, the prevalence of recurrent disease was higher than in patients treated by total thyroidectomy and (131)I administration.
Conclusion:
It appears reasonable to perform total thyroidectomy (possibly associated with central compartment node dissection), (131)I whole body scan (followed by (131)I therapy when necessary) and TSH-suppressive hormonal therapy in patients with PTMC.
