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Papillary carcinoma of the thyroid
K Segal1, R Friedental, E Lubin
1Department of Otolaryngology-Head and Neck Surgery, Beilinson Medical Center, Petah Tikva, Israel.
Summary
Aggressive surgery is recommended for papillary thyroid cancer, based on a nearly 40-year study of over 500 patients. Factors like age, tumor size, and surgical approach significantly impact survival rates.
Area of Science:
- Endocrinology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy.
- Long-term outcomes and prognostic factors for PTC require continuous evaluation.
Purpose of the Study:
- To analyze the long-term outcomes of papillary thyroid carcinoma patients treated over nearly four decades.
- To identify significant predictors of survival in PTC.
Main Methods:
- Retrospective analysis of 503 patients with papillary thyroid carcinoma treated between 1954 and 1993.
- Evaluation of surgical approaches, including total/near-total thyroidectomy and reoperations.
- Histopathological analysis including tumor size, multicentricity, and variant types.
- Assessment of prognostic factors such as age, distant metastases, and surgical type.
Main Results:
- A median follow-up of 10.3 years was recorded.
- Tumor discovery was often linked to lymph node involvement or adjacent structure invasion (over 30%).
- Reoperation was associated with a significantly higher complication rate.
- Multicentricity was observed in 65% of cases with bilateral lobe examination.
- The 15-year mortality rate was 6.2%.
- Age, tumor size, distant metastases, "tall" cell variant, and surgical approach were significant predictors of survival.
Conclusions:
- An aggressive surgical approach is advocated for papillary thyroid carcinoma.
- Understanding prognostic factors is crucial for optimizing patient management and survival outcomes.