Characteristics and significance of minimal and maximal extrathyroidal extension in papillary thyroid carcinoma

Jin, Bong Joon; Kim, Moo Keon; Ji, Yong Bae; Song, Chang Myeon; Park, Jung Hwan; Tae, Kyung

doi:10.1016/j.oraloncology.2015.05.010

Cited by 63 publications

(48 citation statements)

References 21 publications

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“…Generally, neck dissection was not performed prophylactically. [12,20–22,24] According to the data in our study, the patients with mETE had a worse prognosis including a lower DFS rate and an increased recurrence rate compared with the patients without ETE, perhaps because the mETE group had larger tumor sizes, higher rate of bilateral involvement, and more frequent lymph node metastasis than the group without ETE.…”

Section: Discussionmentioning

confidence: 65%

“…The result showed that mETE was related to an increased risk of worse DFS in patients with PTC after initial surgery in 7 studies, [9,10,12,22–24] leading to a significantly unfavorable prognosis (Fig. 3; HR = 1.65, 95% CI: 1.17–2.33, P = 0.004, I 2 = 0%).…”

Section: Resultsmentioning

confidence: 98%

“…The authors of the included studies were from the USA [12,20,25] (n = 3), Korea [10,22–24] (n = 4), and Japan [9,21] (n = 2). Of the 9 included studies, 1 directly reported HRs, 6 required estimation from survival curves, and another 2 studies had no data about RFS or DFS curves.…”

Section: Resultsmentioning

confidence: 99%

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Prognostic impact of minimal extrathyroidal extension in papillary thyroid carcinoma

Yin

et al. 2016

Medicine

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Section: Discussionmentioning

confidence: 65%

Section: Resultsmentioning

confidence: 98%

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Prognostic impact of minimal extrathyroidal extension in papillary thyroid carcinoma

Yin

et al. 2016

Medicine

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“…On histology, ETE can be categorized by extent of invasion, from gross ETE invading major structures to minimal ETE identified only by microscopy. Since the sixth edition of the AJCC TNM staging system for DTC first used minimal ETE as a staging variable, several studies have investigated its prognostic significance. Although there is general agreement that gross ETE invading major structures is independently associated with poor prognosis, there is little evidence to support minimal ETE as an independent predictor of persistence/recurrence or survival.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of gross extrathyroidal extension invading only strap muscles in differentiated thyroid carcinoma

Park

Kim

et al. 2018

British Journal of Surgery

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Background: In the eighth edition of the AJCC staging system for differentiated thyroid carcinoma (DTC), minimal extrathyroidal extension (ETE) is no longer a determinant of T3 category. Instead, gross ETE invading only strap muscles has been designated as a new T3b category. The long-term prognosis of patients with DTC and gross ETE invading only strap muscles was investigated. Methods: This was a retrospective analysis of patients who underwent thyroidectomy between 1996 and 2005. Differences in cancer-specific and recurrence-free survival according to extent of ETE were assessed.Results: A total of 3174 patients with DTC were included. No significant differences were observed in 10-year cancer-specific survival among patients with no ETE (98⋅6 per cent), microscopic ETE (98⋅3 per cent) and gross ETE invading only strap muscles (98⋅9 per cent) (P = 0⋅375). The 10-year recurrence-free survival rate for patients with gross ETE invading only strap muscles (89⋅2 per cent) was shorter than that for patients with no ETE (93⋅7 per cent; P = 0⋅016), but similar to that of patients with microscopic ETE (90⋅3 per cent). In univariable analysis, patients with gross ETE invading only strap muscles had a significantly higher risk of recurrence than those with no ETE (hazard ratio (HR) 1⋅67, 95 per cent c.i. 1⋅10 to 2⋅55; P = 0⋅017). In multivariable analysis, gross ETE invading only strap muscles was not an independent predictor of recurrence (HR 1⋅09, 0⋅71 to 1⋅69; P = 0⋅685). Conclusion:Although gross ETE invading only strap muscles may provide prognostic information about long-term recurrence, it does not affect mortality. The actual impact of gross ETE invading only strap muscles will be important in revising the staging system in the future.

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“…Outcomes from gross ETE are worse than those from microscopic ETE [14,15]. Recent studies have reported that microscopic ETE is not associated with increased recurrence or decreased survival in patients with PTC [16]. In addition, the insignificance of microscopic ETE is equally applied to PTMC, where it has no impact on recurrence in tumors <1 cm [17].…”

Section: Discussionmentioning

confidence: 99%

Predicting Extrathyroidal Extension in Patients With Papillary Thyroid Microcarcinoma According to a BRAF Mutation

Lee

Hwang

et al. 2017

Clin Exp Otorhinolaryngol

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ObjectivesThe aim of this study was to evaluate the association between preoperative parameters and extrathyroidal extension (ETE) of papillary thyroid microcarcinoma (PTMC) according to the BRAF mutation and to evaluate the preoperative predictability of ETE.MethodsWe analyzed the medical records of 332 patients with PTMC (140 in the BRAF– group and 192 in the BRAF+ group). The presence of ETE was subjected to a correlation analysis with age, sex, tumor size, clinical nodal status, and ultrasonography (US) findings. Among the US findings, the correlation between tumors and the thyroid capsule was categorized into four groups; US group A, intraparechymal; US group B, tumor abutting the capsule <50% of diameter; US group C, tumor abutting >50% of diameter; and US group D, tumor destroyed the capsule. The predictive value of ETE, including sensitivity, specificity, and positive and negative predictive values were evaluated.ResultsTumor size and US group were significantly correlated with gross ETE in the BRAF– and BRAF+ groups. Tumor size of 0.5 cm and US groups B and C in the BRAF– group were cutoff values for gross ETE, with a negative predictive value of 100%, whereas tumor size of 0.7 cm and US groups A and B in the BRAF+ group had negative predictive values of 92.4% and 100%, respectively.ConclusionExcluding of ETE by US was categorized according to tumor size and US findings. A different categorization to exclude ETE is needed according to the BRAF mutation.

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Characteristics and significance of minimal and maximal extrathyroidal extension in papillary thyroid carcinoma

Cited by 63 publications

References 21 publications

Prognostic impact of minimal extrathyroidal extension in papillary thyroid carcinoma

Prognostic impact of minimal extrathyroidal extension in papillary thyroid carcinoma

Prognostic significance of gross extrathyroidal extension invading only strap muscles in differentiated thyroid carcinoma

Predicting Extrathyroidal Extension in Patients With Papillary Thyroid Microcarcinoma According to a BRAF Mutation

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