A retrospective analysis of 121 papillary thyroid carcinomas was made to assess prognostic factors including histological variants which might be related to survival. The mean follow-up period was 10 years and clinical, surgical and histopathological data were studied. The survival curves were analysed by the Kaplan-Meier method and the multivariate analysis used Cox's regression model. Eighty-seven patients had well differentiated papillary cancers. The survival rate for papillary thyroid cancer was 86 per cent at 5 years and 72 per cent at 10 years. Factors showing prognostic significance for survival were tumour size, extrathyroid extension and histological type. Disease-free survival was influenced by sex, existence of a capsule and nodal metastases. Factors showing a favourable prognosis were: age under 45 years, size less than 4 cm, no extrathyroid extension and well differentiated histological type (P < 0.001). Histological subtype was one of the most important prognostic factors.
Resultados del tratamiento del microcarcinoma papilar de tiroides adaptado al riesgo de recurrencia
Results of treatment of papillary thyroid microcarcinoma adapted to risk of recurrence
Background:The incidence of papillary thyroid microcarcinoma (PTMC) is increasing. Objective: The objective of the study was to analyze the long-term prognosis of PTMC. Method: Study population: patients with a histopathological diagnosis of PTMC (size ≤ 1 cm) treated according to the risk of recurrence of the Latin American Thyroid Society. Inclusion criteria: the following criteria were included in the study: minimum follow-up of 2 years, availability of histopathological samples, and treatment compliance. Exclusion criteria: the following criteria were excluded from the study: previous thyroid surgery, other synchronous malignancies, or ectopic location of the PTMC. Study variables: persistence, recurrences, and mortality. Results: Based on the risk of recurrence, PTMC has very low risk in 65.2% (n = 105), low risk in 17.4% (n = 28), and high risk in 17.4% (n = 28). In high-risk patients, total thyroidectomy was performed in all cases, cervical lymphadenectomy in 57.1% (n = 16), and metabolic therapy with 131 I in all cases. During a mean follow-up of 119.8 ± 65 months, 0.6% (n = 1) of recurrences took place. Risk factors associated to recurrence were not identified. No patient died due to MCPT. Conclusions: PTMC treated based on its risk of recurrence has a good long-term prognosis, without persistence, with a low number of recurrences and absence of disease-associated mortality.
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