Symptomatic versus Asymptomatic Papillary Thyroid Microcarcinoma: A Retrospective Analysis of Surgical Outcome and Prognostic Factors.

Sugitani, Iwao; Fujimoto, Yoshihide

doi:10.1507/endocrj.46.209

Cited by 153 publications

(118 citation statements)

References 32 publications

Supporting

Mentioning

105

Contrasting

Unclassified

Order By: Relevance

“…A number of large, retrospective studies show a significant reduction in the rates of disease recurrence (61,98,99,126) and cause-specific mortality (98,99,(126)(127)(128). However, other similar studies show no such benefit, at least among the majority of patients with papillary thyroid carcinoma, who are at the lowest risk for mortality (68,101,(128)(129)(130)(131). In those studies that show benefit, the advantage appears to be restricted to patients with larger tumors (Ͼ 1.5 cm), or with residual disease after surgery, while lower risk patients do not show evidence for benefit (68,98,132).…”

Section: What Is the Role Of Postoperative Radioiodine Remnant Ablation?mentioning

confidence: 99%

Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Taskforce

Cooper

Doherty

Haugen

et al. 2006

Thyroid

1,916

938

View full text Add to dashboard Cite

Section: What Is the Role Of Postoperative Radioiodine Remnant Ablation?mentioning

confidence: 99%

Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Taskforce

Cooper

Doherty

Haugen

et al. 2006

Thyroid

1,916

938

View full text Add to dashboard Cite

“…In contrast, however, the prevalence of clinical thyroid papillary carcinoma was 1.9-11.7 per 100,000 females of all ages [3,10], which is about 1,000 times lower than that of PMC detected on ultrasonography. The marked difference between these prevalences suggests that PMC rarely grow and become clinically apparent, prompting the question of whether immediate surgery is mandatory for all PMC detected on mass screening, although PMC is also known to show multicentricity in 15-44% of lesions and regional lymph node metastasis in 14-64% of lesions [11][12][13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

An Observational Trial for Papillary Thyroid Microcarcinoma in Japanese Patients

et al. 2009

View full text Add to dashboard Cite

Background The recent development and spread of ultrasonography and ultrasonography-guided fine needle aspiration biopsy (FNAB) has facilitated the detection of small papillary microcarcinomas of the thyroid measuring 1 cm or less (PMC). The marked difference in prevalence between clinical thyroid carcinoma and PMC detected on mass screening prompted us to observe PMC unless the lesion shows unfavorable features, such as location adjacent to the trachea or on the dorsal surface of the thyroid possibly invading the recurrent laryngeal nerve, clinically apparent nodal metastasis, or high-grade malignancy on FNAB findings. In the present study we report comparison of the outcomes of 340 patients with PMC who underwent observation and the prognosis of 1,055 patients who underwent immediate surgery without observation. Methods Between 1993 and 2004, 340 patients underwent observation and 1,055 underwent surgical treatment without observation. These 1,395 patients were enrolled in the present study. Observation periods ranged from 18 to 187 months (average 74 months). Results The proportions of patients whose PMC showed enlargement by 3 mm or more were 6.4 and 15.9% on 5-year and 10-year follow-up, respectively. Novel nodal metastasis was detected in 1.4% at 5 years and 3.4% at 10 years. There were no factors related to patient background or clinical features linked to either tumor enlargement or the novel appearance of nodal metastasis. After observation 109 of the 340 patients underwent surgical treatment for various reasons, and none of those patients showed carcinoma recurrence. In patients who underwent immediate surgical treatment, clinically apparent lateral node metastasis (N1b) and male gender were recognized as independent prognostic factors of disease-free survival. Conclusions Papillary microcarcinomas that are not associated with unfavorable features can be candidates for observation regardless of patient background and clinical features. If there are subsequent signs of progression, such as tumor enlargement and novel nodal metastasis, it would not be too late to perform surgical treatment. Even though the primary tumor is small, careful surgical treatment including therapeutic modified neck dissection is necessary for N1b PMC patients.

show abstract

“…8 Although its clinical significance in papillary microcarcinomas is somewhat controversial, several authors have reported that lymph node metastasis at presentation is correlated with loco-regional recurrence in papillary microcarcinomas. 5,[9][10][11] Moreover, lymph node metastasis is reported to be associated with distant metastasis of papillary microcarcinomas. [9][10][11] In the new TNM (tumor, node, metastases) staging system, lymph node metastasis is a more important factor than tumor size in overall staging.…”

mentioning

confidence: 99%

“…5,[9][10][11] Moreover, lymph node metastasis is reported to be associated with distant metastasis of papillary microcarcinomas. [9][10][11] In the new TNM (tumor, node, metastases) staging system, lymph node metastasis is a more important factor than tumor size in overall staging. 12 Overexpression of cyclin D1, 13 S100A4 14 and MUC1, 15 loss of p27 13,16 and presence of the BRAF mutation 17,18 have been suggested as important predictive factors for relapse or nodal metastasis of papillary thyroid carcinoma.…”

mentioning

confidence: 99%

S100A4 expression is associated with lymph node metastasis in papillary microcarcinoma of the thyroid

et al. 2008

View full text Add to dashboard Cite

The detection of papillary microcarcinomas of the thyroid is increasing due to frequent use of ultrasound and fine-needle aspiration biopsy. Although most of the papillary microcarcinomas remain quiescent and follow an indolent clinical course, some behave aggressively and metastasize early, giving rise to clinically significant disease. There have been few studies concerning factors predictive of lymph node metastasis in papillary microcarcinomas. We analyzed the expression of S100A4, cyclin D1, p27 and MUC1, the presence of the BRAF V600E mutation and the clinicopathological features of the tumors, including patient age, tumor size (Z5 vs o5 mm), extrathyroidal extension, multifocality, histological subtype, sclerosis and encapsulation, in a series of 198 papillary microcarcinomas in relation to lymph node metastasis to determine the predictive factors of lymph node metastasis. On univariate analysis, tumor size of 5 mm or more, extrathyroidal extension, multifocality, sclerosis and the expression of S100A4 and cyclin D1 predicted lymph node metastasis, whereas patient age, expression of p27 and MUC1 and the BRAF V600E mutation did not. Moreover, tumor size 5 mm or more, multifocality and expression of S100A4, especially its strong expression in the invasive fronts, were significantly associated with macrometastasis and lateral node metastasis. On multivariate analysis, multifocality and expression of S100A4 were found to be common independent predictive factors of lymph node metastasis, macrometastasis and lateral node metastasis. In conclusion, S100A4 expression in papillary microcarcinomas may indicate the presence of nodal metastasis. Thus, S100A4 immunohistochemistry may be valuable for predicting metastatic potential in papillary microcarcinomas.

show abstract

Symptomatic versus Asymptomatic Papillary Thyroid Microcarcinoma: A Retrospective Analysis of Surgical Outcome and Prognostic Factors.

Abstract: Abstract.Although the mortality rate associated with papillary microcarcinoma

Cited by 153 publications

References 32 publications

Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Taskforce

Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Taskforce

An Observational Trial for Papillary Thyroid Microcarcinoma in Japanese Patients

S100A4 expression is associated with lymph node metastasis in papillary microcarcinoma of the thyroid

Contact Info

Product

Resources

About