Prognostic impact of tumour multifocality in thyroid papillary microcarcinoma based on a series of 160 cases

Riss, J.; Peyrottes, Isabelle; Chamorey, Emmanuel; Haudebourg, Juliette; Sudaka, Anne; Benisvy, Danielle; Marcy, Pierre-Yves; Nao, E.-E.-M.; Démard, F; Vallicioni, J; Poissonnet, G.; Dassonville, O.; Santini, J.; Bozec, Alexandre

doi:10.1016/j.anorl.2011.11.003

Cited by 22 publications

(21 citation statements)

References 9 publications

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“…Similar to our results (although with different inclusion criteria), others found no association between multifocality and tumour recurrence [39,40]. Thus, the prognosis of multifocal nature of the disease remains controversial, although the recently developed ATA guidelines [6] have associated a higher risk of tumour recurrence of 4-6% with multifocal disease regardless of the tumour size.…”

Section: Discussionsupporting

confidence: 80%

Low-Dose Radioiodine Ablation in Patients with Low-Risk Differentiated Thyroid Cancer

et al. 2018

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Aim: Based on the response criteria of the 2015 American Thyroid Associations guidelines, our objectives were to determine the response rate when using a low dose of 131-I GBq in patients with low-risk differentiated thyroid cancer (LRDTC) and the influence of clinical and analytical variables on the prediction of complete response. Methods: We performed a multicentre and longitudinal study, including patients who were operated for LRDTC and who underwent radioiodine remnant ablation with a low-dose of 131-I. All patients were assessed at 6–12 months, and their status was classified as complete (excellent response) or incomplete response (structural incomplete, biochemical incomplete or indeterminate response). Various factors including age, gender, histology, tumour focality and size, stage, time from surgery to treatment, type of thyroid-stimulating hormone (TSH) stimulation, preablation serum thyroglobulin (pTg), antiTg antibodies (pAntiTgAb) and TSH (pTSH) levels were also analysed in order to predict the complete response rate. Results: Of 108 patients, 79.6% achieved complete response and the remaining showed incomplete response (2.9, 5.5 and 12% due to biochemical incomplete, structural incomplete and indeterminate response respectively). Six patients received a new dose of 131-I. Tumour size and pAntiTgAb were the only factors related to therapeutic response (p = 0.03 and p < 0.01, respectively). However, pAntiTgAb was the only independent factor related to complete response. Patients with complete response showed lower pTg than those with incomplete response (5.1 ± 12.9 vs. 11.2 ± 25 ng/mL) although without statistical significance (p = 0.14). There was no significant difference in the response rate depending on the thyrotropin stimulation methods. Conclusions: A low dose of 131-I was sufficient for reaching a complete response at 6–12 months of follow-up in the majority of patients with LRDTC. Tumour size and pAntiTgAb variables were related to therapeutic response.

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Section: Discussionsupporting

confidence: 80%

Low-Dose Radioiodine Ablation in Patients with Low-Risk Differentiated Thyroid Cancer

et al. 2018

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“…Extrathyroidal extension was another predictor for recurrence, consistent with previous studies [17][18][19]. However, some studies of the prognostic impact of tumor multifocality in papillary thyroid microcarcinoma (PTMC) have suggested that multifocal lesions do not appear to have prognostic impact in PTMC [20]. Given the high incidence of multifocality in PTMC, 20-40% [21][22][23], further studies of small PTC tumors are needed to investigate the true role and influence of multifocality in this subtype of PTC.…”

Section: Discussionsupporting

confidence: 63%

Predictive Factors for Occult Contralateral Papillary Thyroid Carcinoma in Patients with Ipsilateral Multifocality on Frozen Biopsy

Park¹,

Lee²,

Lee³

et al. 2017

Korean J Otorhinolaryngol-Head Neck Surg

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Background: Papillary thyroid cancer (PTC) often presents as multifocal. However, the association of multifocality with poor prognosis remains controversial. The aim of this retrospective study was to identify the characteristics of PTC with multiple foci and to evaluate the association between multifocality and prognosis. Methods: We reviewed the medical records of 496 patients who underwent total thyroidectomy for PTC. Patients were classified as G1 (1 tumor focus), G2 (2 foci), and G3 (3 or more foci). We analyzed the clinicopathological features and clinical outcomes in each classification. A Cox regression model was used to assess the relationship between multifocality and recurrence or cancer mortality. Results: The G1, G2 and G3 groups included 287, 141 and 68 patients, respectively. The mean age was 47.1 ± 16.1 yr in G1, 41.1 ± 18.4 yr in G2, and 35.5 ± 15.9 yr in G3 and differed significantly among the 3 groups (p = 0.001). The proportion of extrathyroidal extension, central lymph node metastasis (CLNM), and lateral lymph node metastasis (LLNM) in the G1 to G3 groups increased with increasing number of tumor foci. The Kaplan-Meier curves revealed that G3 had the shortest recurrence-free survival, and differences were significant among the 3 groups (p = 0.001, Log Rank test). Furthermore, cancer-specific survival rates decreased significantly with increasing number of tumor foci (p = 0.041). Independent predictors of recurrence by multivariate Cox analysis included >3 tumor foci [HR 2.60, 95% confidence interval (CI) 1.53-4.39, p = 0.001] and extrathyroidal extension (HR 1.95, CI 1.12-3.38, p = 0.018). Conclusion: An increase in the number of tumors is associated with a tendency toward more aggressive features and predicts poor prognosis in PTC.

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“…However, some studies on the prognostic impact of tumour multifocality in PTC especially microcarcinomas have suggested that multifocal lesions do not appear to have prognostic impact [35]. Our study has shown that the size of concurrent tumours is important on whether multifocality represents greater tumour burden and better predictor of more aggressive behaviour of papillary thyroid cancer.…”

Section: Discussionmentioning

confidence: 69%

Predictors of incomplete response to therapy among Filipino patients with papillary thyroid cancer in a tertiary hospital

Lopez

Valdez

et al. 2015

J Endocrinol Invest

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A significant fraction of PTC patients experienced incomplete response to therapy. Our data suggest that male gender, lateral or mediastinal lymph node involvement, class III extent of disease by De Groot and multifocality with concurrent tumour or tumours more than 1 cm are major predictors of incomplete response. Not all predictors of recurrence and mortality are consistent predictors of treatment response which may be equally important in a disease with low mortality but significant morbidity like PTC.

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Prognostic impact of tumour multifocality in thyroid papillary microcarcinoma based on a series of 160 cases

Abstract: Tumour multifocality does not appear to have a prognostic impact in PTMC.

Cited by 22 publications

References 9 publications

Low-Dose Radioiodine Ablation in Patients with Low-Risk Differentiated Thyroid Cancer

Low-Dose Radioiodine Ablation in Patients with Low-Risk Differentiated Thyroid Cancer

Predictive Factors for Occult Contralateral Papillary Thyroid Carcinoma in Patients with Ipsilateral Multifocality on Frozen Biopsy

Predictors of incomplete response to therapy among Filipino patients with papillary thyroid cancer in a tertiary hospital

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