Differentiated thyroid cancers 11-20 mm in diameter have clinical and histopathologic characteristics suggesting higher aggressiveness than those < or =10 mm.
OBJECTIVE
To compare characteristics and outcomes of differentiated thyroid cancers < or =10 mm with those 11-20 mm in diameter.


METHODS
Retrospective chart review of 426 patients with thyroid carcinoma < or =20 mm diagnosed and treated between 1990 and 2004 in one university clinic.


RESULTS
Lymph node metastases were more frequent at diagnosis in 11-20 mm than in < or =10 mm cancers (p < 0.001). The prevalence of distant metastases did not differ between < or =10 mm and 11-20 mm cancers. One hundred and thirty-three patients (73%) with tumors 11-20 mm were disease free 2 years after 131I treatment, and no recurrence has been observed over 2-14 years of follow-up. Forty-one patients (22%) with cancers 11-20 mm (N1 or M1) required 2-4 years to become disease free. Neck lymph node recurrence was observed in nine patients (4.9%) 4 months to 14 years after surgery and (131)I therapy. Four patients (1.6%) with cancers < or =10 mm in diameter had cancer recurrence (p = 0.05 compared to the 11-20 mm cancers). Based on the presence of distant metastases at diagnosis and recurrence of disease during follow-up, cancers 11-20 mm in diameter seemed more aggressive than those < or =10 mm (p < 0.05).


CONCLUSIONS
Cancers 11-20 mm seem more aggressive than those < or =10 mm.
Rossi
Roberta
R
Section of Endocrinology, Department of Biochemical Sciences and Advanced Therapies, University of Ferrara, Ferrara, Italy.
Roti
Elio
E
Trasforini
Giorgio
G
Pansini
Giancarlo
G
Cavazzini
Luigi
L
Zatelli
Maria Chiara
MC
Pearce
Elizabeth N
EN
Braverman
Lewis E
LE
Uberti
Ettore C Degli
EC
D000328:Adult; D002291:Carcinoma, Papillary / Q000453:epidemiology / Q000532:radiotherapy / Q000556:secondary*; D002454:Cell Differentiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008175:Lung Neoplasms / Q000453:epidemiology / Q000556:secondary*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008479:Mediastinal Neoplasms / Q000453:epidemiology / Q000556:secondary*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000532:radiotherapy
D007457:Iodine Radioisotopes