Predictors for papillary thyroid cancer persistence and recurrence: a retrospective analysis with a 10‐year follow‐up cohort study

Castro, Taciana Padilha de; Waissmann, William; Simões, Taynãna César; Mello, Renata; Carvalho, Denise P.

doi:10.1111/cen.13032

Cited by 28 publications

(26 citation statements)

References 34 publications

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“…Following title and abstract screening step, we identified 39 potential articles to read full texts. We excluded 13 articles after carefully reading full texts, leaving 26 studies with a total of 8834 PTCs and 3127 FTCs that were included for final analysis (5,7,8,9,10,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38) (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Prognostic impact of vascular invasion in differentiated thyroid carcinoma: a systematic review and meta-analysis

Vuong

Kondo

Duong

et al. 2017

European Journal of Endocrinology

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Section: Resultsmentioning

confidence: 99%

Prognostic impact of vascular invasion in differentiated thyroid carcinoma: a systematic review and meta-analysis

Vuong

Kondo

Duong

et al. 2017

European Journal of Endocrinology

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“…Persistence was defined as evident structural and/or biochemical residual disease (active disease status) until 1‐year after the initial surgery. Recurrence was considered when the first event of the active disease occurred after 1‐year follow‐up . Follow up outcomes of patients were evaluated and compared.…”

Section: Methodsmentioning

confidence: 99%

“…Recurrence was considered when the first event of the active disease occurred after 1-year follow-up. 10 Follow up outcomes of patients were evaluated and compared. Table 3).…”

Section: Methodsmentioning

confidence: 99%

A cancer of undetermined significance: Incidental thyroid carcinoma

Evranos¹,

Polat

Cuhaci

et al. 2018

Diagnostic Cytopathology

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Introduction The incidence of thyroid cancer is increasing which can be attributed in part to improved ultrasonography (US) methods and increased detection of incidental thyroid carcinomas (ITC). We aimed to compare ITC with nonincidental thyroid carcinomas (NITC) in this study. Methods Retrospective analyses of 906 individual patients who were operated for benign and malignant thyroid disease and had a final histopathological diagnosis of thyroid carcinoma were enrolled in this study. Preoperative US examination and fine needle aspiration (FNA) biopsy results were evaluated. The tumor foci in thyroidectomy specimens that were not represented in preoperative US or FNA reports were classified as ITC. The tumor foci that match with the lesions defined in US or FNA results were classified as NITC. Results Final histology revealed ITC in 326 patients (36%) and NITC in 580 patients (64% Mean age was 51.7 ± 11.11 in ITC group and 48.15 ± 13.1 in NITC group (P < .001). In NITC group 322 (55.5%) of the patients were operated for suspicious cytology while only 29 (8.9%) of the patients in the ITC group were operated because of this indication (P < .001). There were 1301 cancer foci in histopathology specimens. Among all these cancer foci, 434 (33.3%) were detected incidentally and 867 (66.7%) were detected non‐incidentally. About 779 (89.9%) of nonincidental cancer foci were papillary cancer (PTC), while all of the incidental cancer foci were PTC. Mean size was 13 mm in NITC group and it was 3 mm in the ITC group and differed significantly between the groups (P < .001). Tumor size was ≤1 cm in 35.2% of the patients with NITC while 98.5% of patients with ITC had tumor ≤1 cm. The occurrence of multinodularity was higher in ITC than the NITC group (P < 001). Median TSH level was higher in patients with NITC than ITC while both were in the reference range (1.53 vs 1.03 μIU/mL, P < .001). The frequency of thyroiditis detected by US, and thyroid peroxidase antibody and thyroglobulin antibody positivities were similar in patients with ITC and NITC (P = .2, P = .86, and P = .26, respectively). The frequencies of capsular invasion (29.1% vs 7.9%), extrathyroidal extension (13% vs 4.2%), multifocality (35.8% vs 24.2%), non‐complete resection (9.2% vs 1.8%), and lymph node metastasis (9.5% vs 1.8%) were significantly higher in the NITC group (P < .001, for each). Persistent/recurrent disease in patients with NITC was more frequent than patients with ITC (P = .004). This outcome was similar for cancers measuring ≤1 cm (P = .001). Conclusion ITC is often encountered in older patients and frequently determined in early stages with more favorable histopathological features and better prognosis.

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“…In most studies, the persistence and recurrence of DTC after initial treatment have been indistinctly de ned with no clear separation. Few studies have investigated the di erence between persistent and recurrent disease in terms of disease outcomes and survival rates [13][14][15]. In a recent study, Sapuppo et al [13] emphasized the importance of this distinction and de ned each disease status separately.…”

Section: Discussionmentioning

confidence: 99%

Microscopic Positive Tumor Margin Increases Risk for Disease Persistence but Not Recurrence in Patients with Stage T1-T2 Differentiated Thyroid Cancer

Hasan

Brabandere

Rachinsky

et al. 2020

Journal of Thyroid Research

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Introduction. Differentiated thyroid cancer (DTC) has an overall excellent prognosis. Patients who develop recurrent disease have a more unfavorable disease course than those with no recurrence. Higher recurrence rates are seen with incomplete surgical resection and gross positive margins. It is unclear whether microscopic positive margin affects disease recurrence rates as much as grossly positive margin. Aim of the Study. To assess whether microscopic positive margin is an independent predictor of disease recurrence in patients with overall low-risk DTC. Patients and Methods. We conducted a retrospective single-center institutional review of 1,583 consecutive patients’ charts from 1995–2013 using the Canadian Thyroid Cancer Consortium Registry. We included adult patients with nonmetastasizing T1 and T2 DTC with a minimum of three years follow-up. Univariate and multivariate analyses were used to study factors that may influence the risk of persistent/recurrent disease. Strict definitions of persistent versus recurrent disease were applied. Results. 963 patients (152 men and 811 women) were included in the study with a mean age of 46 years. Microscopic positive margins were present in 12% of the specimens and were associated with an increased rate of persistent disease (8% versus 2% in the controls) but not with an increased risk of recurrent disease (1% in both groups). T2 tumors had a significantly higher incidence of positive margins than T1 tumors (48% versus 36%) and significantly higher nodal staging. Conclusions. Microscopic positive margin in the histopathology report in patients with low-risk DTC was associated with a higher rate of persistent disease but did not increase the risk of disease recurrence. A close follow-up of biomarkers and occult residual cancerous lesions is needed, especially in the first year. Further studies are needed to determine whether additional therapeutic measures to prevent recurrence are indicated in T1 and T2 DTC with positive microscopic surgical margins.

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Predictors for papillary thyroid cancer persistence and recurrence: a retrospective analysis with a 10‐year follow‐up cohort study

Abstract: The best predictors of persistence were tumour size and macroscopic lymph node metastasis; when the initial surgery is of quality, the recurrence depends more on tumour's biology aspects.

Cited by 28 publications

References 34 publications

Prognostic impact of vascular invasion in differentiated thyroid carcinoma: a systematic review and meta-analysis

Prognostic impact of vascular invasion in differentiated thyroid carcinoma: a systematic review and meta-analysis

A cancer of undetermined significance: Incidental thyroid carcinoma

Microscopic Positive Tumor Margin Increases Risk for Disease Persistence but Not Recurrence in Patients with Stage T1-T2 Differentiated Thyroid Cancer

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