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Papillary thyroid microcarcinoma with minimal extrathyroidal extension. Is its course so indolent that it requires a
J Ruiz Pardo1, A Ríos Zambudio2, J M Rodríguez González2
1Servicio de Cirugía General y de Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
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 And Methods:
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 2years. 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% (n=18) of patients. On the multivariate analysis, mETE was associated with age ≥45 years (OR: 4.383; 95% CI: 1.051-18.283, p = .043), tumor size ≥8mm (OR: 5.913; 95% CL: 1.795-19.481; p = .003), bilaterality (OR: 4.430; 95% CI: 1.294-15.173; p = .018) and metastatic lymph nodes (OR: 12.588; 95% CI: 2.919-54.280; p = .001). During a mean follow-up of 119.8±65 months, one recurrence was detected in group 2 (0% vs. 5.6%; p = .112). No patients died of the disease. Disease-free survival was lower in group 2 (124.9±5.6 vs. 97.4±10.3 months; p = .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.
Insights
Minimal extrathyroidal extension (mETE) in papillary thyroid microcarcinoma (PTMC) is linked to worse prognosis. This finding highlights the importance of considering mETE in PTMC patient outcomes.
Area of Science:
- Endocrinology
- Oncology
- Pathology
Background:
- Papillary thyroid microcarcinoma (PTMC) incidence is rising.
- The prognostic significance of minimal extrathyroidal extension (mETE) in PTMC remains unclear.
Purpose of the Study:
- To identify factors associated with PTMC exhibiting mETE.
- To evaluate the long-term prognosis of PTMC with mETE.
Main Methods:
- Retrospective study of patients with PTMC.
- Exclusion criteria: prior thyroid surgery, other malignancies, ectopic PTMC, loss to follow-up within 2 years.
- Comparison between PTMC without mETE and PTMC with mETE using multivariate analysis.
Main Results:
- mETE was observed in 11.2% of PTMC patients.
- Factors associated with mETE: age ≥45 years, tumor size ≥8mm, bilaterality, and metastatic lymph nodes.
- Lower disease-free survival in the mETE group (p = .034).
Conclusions:
- mETE in PTMC is a marker of worse prognosis.
- mETE is associated with metastatic lymph nodes and reduced disease-free survival in PTMC.
- No disease-related deaths were observed.
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