Small papillary thyroid carcinoma with minimal extrathyroidal extension should be managed as ATA low-risk tumor
| Autor: | nbsp, Castagna, M. , Forleo, R., Maino, F., Fralassi, N., Barbato, F., Palmitesta, P., Pilli, T., Capezzone, M., Brilli, L., Ciuoli, C., Cantara, S., Formichi, C., Pacini, F. |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Disease Gastroenterology Papillary thyroid cancer Thyroid carcinoma Young Adult 03 medical and health sciences aggressive histology micropapillary thyroid cancer minimal extrathyroidal extension PTC tumor diameter 0302 clinical medicine Endocrinology Risk Factors Internal medicine Humans Medicine Voluntary Health Agencies Child Lymph node Aged Retrospective Studies Aged 80 and over Tumor size business.industry Thyroid Disease Management Guideline Middle Aged medicine.disease Dissection medicine.anatomical_structure Thyroid Cancer Papillary 030220 oncology & carcinogenesis Practice Guidelines as Topic Thyroidectomy Female business Follow-Up Studies |
| Zdroj: | Journal of Endocrinological Investigation. 41:1029-1035 |
| ISSN: | 1720-8386 |
| Popis: | According to American Thyroid Association (ATA) guideline, papillary thyroid cancer (PTC) with minimal extrathyroidal extension (mETE) is classified at “intermediate risk” of persistent/recurrent disease. However, the impact of mETE per se on patients’ outcome is not fully understood. The aim of our study was to evaluate the prognostic significance of mETE in patients with PTC not submitted to therapeutic or prophylactic lymph node dissection, according to tumor size and other prognostic factors. We retrospectively evaluated a total of 514 PTC patients: 127 (24.7%) had mETE (pT3Nx) and 387 (75.3%) had negative margins (pT1-2Nx). At a median follow-up of 9.1 years, patients were divided in two groups: patients with “good outcome” (no evidence of disease) and patients with “poor outcome” (persistent structural disease or recurrent disease or tumor-related death). The rate of patients with “poor outcome” was significantly higher in patients with mETE compared with patients with negative margins (11.8 versus 5.1%; OR 2.4576, 95% CI 1.2178–4.9594, p = 0.01). However, mETE was significantly associated with poor outcome only in patients with tumors larger than 1.5 cm. mETE is an unfavorable prognostic factor in tumors larger than 1.5 cm, suggesting that, in the absence of other unfavorable characteristics, smaller tumors with mETE should be classified and managed as “low risk” tumors. |
| Databáze: | OpenAIRE |
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