Results of the treatment of papillary thyroid microcarcinoma adapted to risk of recurrence

Abstract

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.