Incidental thyroid papillary microcarcinoma: survival and follow‐up

Gorostis, Sophie; Raguin, T.; Schneegans, Olivier; Takeda, Catherine; Debry, Christian; Dupret‐Bories, Agnès

doi:10.1002/lary.27664

Cited by 10 publications

(9 citation statements)

References 26 publications

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“…Cervical LNM is a common finding in PTC, affecting 20% to 80% of patients [20,21]. Some authors state that clinically evident cervical LNM seems to be the fundamental indicator in terms of prognosis [32]. PTC frequently recurs in regional lymph nodes [28] and cervical LNM, at initial surgery, increases the incidence of recurrent disease during follow-up [30,32] and decreases DSS in some studies.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors state that clinically evident cervical LNM seems to be the fundamental indicator in terms of prognosis [32]. PTC frequently recurs in regional lymph nodes [28] and cervical LNM, at initial surgery, increases the incidence of recurrent disease during follow-up [30,32] and decreases DSS in some studies. Controversy exists regarding appropriate surgical management of cervical lymph nodes without evidence of metastases.…”

Section: Discussionmentioning

confidence: 99%

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Clinicopathological Features as Prognostic Predictors of Poor Outcome in Papillary Thyroid Carcinoma

Póvoa

Teixeira

Bella

et al. 2020

Cancers

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Papillary thyroid cancer (PTC) has an indolent nature and usually excellent prognosis. Some PTC clinicopathological features may contribute to the development of aggressive metastatic disease. In this work, we want to evaluate PTC clinicopathological features that are presurgical prognostic predictors of patients’ outcomes and find which indicators are more adequate for tailoring surgical procedures and follow-up. We studied a series of 241 PTC patients submitted to surgery. All patients’ files and histological tumor samples were reviewed. The 8th edition AJCC/UICC (American Joint Committee on Cancer/Union for International Cancer) Controlstaging system and the 2015 American Thyroid Association risk stratification system were used. Total thyroidectomy was performed in 228 patients, lymphadenectomy in 28 patients. Gross extrathyroidal extension (ETE) was present in 10 patients and 31 tumor resection margins were incomplete. Cervical lymph node metastases (LNMs) were present in 34 patients and distant metastases at diagnosis in four patients. In multivariate analysis, male gender (OR = 15.4, p = 0.015), venous invasion (OR = 16.7, p = 0.022), and lateral compartment LNM (OR = 26.7, p = 0.004) were predictors of mortality; psammoma bodies (PBs) (OR = 4.5, p = 0.008), lymph vessel invasion (OR = 6.9, p < 0.001), and gross ETE (OR = 16.1, p = 0.001) were predictors of structural disease status; male gender (OR = 2.9, p = 0.011), lymph vessel invasion (OR = 2.8, p = 0.006), and incomplete resection margins (OR = 4.6, p < 0.001) were predictors of recurrent/persistent disease. Our study supports that the factors helping to tailor patient’s surgery are male gender, presence of PBs, gross ETE, and lateral compartment LNM. Together with pathological factors, lymph vessel invasion, venous invasion, necrosis, and incomplete surgical resection, should be taken into consideration regarding treatment and follow-up of patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinicopathological Features as Prognostic Predictors of Poor Outcome in Papillary Thyroid Carcinoma

Póvoa

Teixeira

Bella

et al. 2020

Cancers

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“…Although PTMC is characterized as a kind of indolent tumor, the presence of lymph node metastasis always relates to unfavorable oncological outcomes. According to previous studies, about 25% to 64% of patients with PTMC have cervical lymph node metastasis (CLNM) ( 3 ), especially in the central compartment ( 4 , 5 ). Meanwhile, PTMC patients with CLNM exhibit a high recurrence rate compared to those without CLNM ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

A Nomogram Based on Clinicopathological and Ultrasound Imaging Characteristics for Predicting Cervical Lymph Node Metastasis in cN0 Unilateral Papillary Thyroid Microcarcinoma

et al. 2021

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Objective: The aim of this study was to establish a practical nomogram for preoperatively predicting the possibility of cervical lymph node metastasis (CLNM) based on clinicopathological and ultrasound (US) imaging characteristics in patients with clinically node-negative (cN0) unilateral papillary thyroid microcarcinoma (PTMC) in order to determine a personal surgical volume and therapeutic strategy.Methods: A total of 269 consecutive patients diagnosed with cN0 unilateral PTMC by postoperative pathological examination from January 2018 to December 2020 were retrospectively analyzed. All the patients underwent lobectomy or thyroidectomy with routine prophylactic central lymph node dissection (CLND) and were divided into a CLNM group and a non-CLNM group. Using logistic regression, the least absolute shrinkage and selection operator (LASSO) regression analysis was applied to determine the risk factors for CLNM in patients with unilateral cN0 PTMC. A nomogram including risk-factor screening using LASSO regression for predicting the CLNM in patients with cN0 unilateral PTMC was further developed and validated.Results: Risk factors identified by LASSO regression, including age, sex, tumor size, presence of extrathyroidal extension (ETE), tumor diameter/lobe thickness (D/T), tumor location, and coexistent benign lesions, were potential predictors for CLNM in patients with cN0 unilateral PTMC. Meanwhile, age (odds ratio [OR] = 0.261, 95% CI.104–0.605; P = 0.003), sex (men: OR = 3.866; 95% CI 1.758–8.880; P < 0.001), ETE (OR = 3.821; 95% CI 1.168–13.861; P = 0.032), D/T (OR = 72.411; 95% CI 5.483–1212.497; P < 0.001), and coexistent benign lesions (OR = 3.112 95% CI 1.407–7.303; P = 0.007) were shown to be significantly related to CLNM by multivariant logistic regression. A nomogram for predicting CLNM in patients with cN0 unilateral PTMC was established based on the risk factors identified by the LASSO regression analysis. The receiver operating characteristic (ROC) curve for predicting CLNM by nomogram showed that the area under the curve (AUC) was 0.777 and exhibited an excellent consistency.Conclusions: A nomogram based on clinical and US imaging characteristics for predicting the probability of CLNM in patients with cN0 unilateral PTMC was developed, which showed a favorable predictive value and consistency. Further prospective research to observe the oncological outcomes is necessary to determine whether the nomogram could potentially guide a personalized surgical volume and surgical approach.

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“…Thyroid microcarcinoma (TMC) refers to thyroid cancer with diameter ≤ 1 cm, also known as occult thyroid cancer [1,2]. TMC has a high prevalence in the population and a previous autopsy study on subjects who died of non-thyroidal diseases revealed latent TMC in up to 5.2% of the subjects [1,3].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Effects of Ultrasound-Guided Percutaneous Laser Ablation for Primary Thyroid Microcarcinoma

Zhou¹,

Yu²,

Sun³

et al. 2021

Preprint

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Background: Ultrasound-guided percutaneous laser ablation, as a minimally invasive ablation method, has been widely used in the treatment of benign and malignant tumors. The objective of the current study is to determine the efficacy and safety of ultrasound-guided percutaneous laser ablation (PLA) for unifocal papillary thyroid micro carcinomas (PTMC).Methods: A total of 18 patients were included in this study. Patients with a single PTMC were treated via the PLA method, and postoperative complications, tumor size and recurrence rate were followed up and recorded.Results: Data suggested that three patients underwent a secondary ablation, and the remaining 15 patients underwent a single ablation without serious complications. No recurrence or metastasis was found among the follow-up patients, and the tumor sizes decreased significantly from 12 months following PLA treatment.Conclusions: Ultrasound-guided PLA is a new therapeutic means that can be used as an alternative to PTMC treatment.

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Incidental thyroid papillary microcarcinoma: survival and follow‐up

Cited by 10 publications

References 26 publications

Clinicopathological Features as Prognostic Predictors of Poor Outcome in Papillary Thyroid Carcinoma

Clinicopathological Features as Prognostic Predictors of Poor Outcome in Papillary Thyroid Carcinoma

A Nomogram Based on Clinicopathological and Ultrasound Imaging Characteristics for Predicting Cervical Lymph Node Metastasis in cN0 Unilateral Papillary Thyroid Microcarcinoma

Therapeutic Effects of Ultrasound-Guided Percutaneous Laser Ablation for Primary Thyroid Microcarcinoma

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