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Understanding the natural history of papillary thyroid cancer: Case series
Jonathan K Lin1, Lori C Sakoda2, Jeanne Darbinian2
1Kaiser Permanente, Oakland Medical Center, Oakland, California.
Background:
Papillary thyroid cancer (PTC) incidence continues to rise. We describe the natural history of untreated PTC patients.
Methods:
Retrospective case series of 31 untreated PTC patients.
Results:
We identified 31 untreated patients from the Kaiser Permanente Cancer Registry with PTC from 1973 to 2010. Patients were categorized as low risk (n = 16), high risk (n = 12), or low risk but medically contraindicated for surgery (n = 3). At diagnosis, 7 (58.3%) in the high-risk group had cervical lymph node metastases and 5 (41.7%) had distant metastases, compared to none in the low-risk group. Among the latter, three (18.8%) patients developed tumor growth >3 mm and one (6.3%) developed regional lymph node metastases without distant metastases. The 10-year overall survival was 71% and 35% for the low-risk and high-risk groups, respectively.
Conclusions:
Patients with low-risk untreated PTC were less likely to develop new regional or distant metastases and had better overall survival than patients with high-risk untreated PTC.
Level Of Evidence:
4.
