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.

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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.