Prognostic parameters for recurrence of papillary thyroid microcarcinoma.
BACKGROUND
Papillary thyroid microcarcinoma (PTMC) is defined as a papillary thyroid carcinoma less than or equal to 1.0 cm in size. Independent prognostic factors for clinical recurrence of PTMC have not been clearly delineated.


METHODS
Clinicopathological parameters predicting PTMC recurrence were determined by retrospective analysis of 307 patients.


RESULTS
Of the 293 patients eligible for analysis, 14 (5%) had recurrence during a median follow-up time of 65 months. Recurrence was observed in 8 of 166 patients (0.5%) treated with total or near-total thyroidectomy; gender (P = 0.02) and presence of lateral cervical node metastases at initial surgery (P = 0.01) were associated with recurrence. Six of the 127 patients (0.5%) treated with hemi- or subtotal thyroidectomy experience recurrences, but no significant prognostic factor for recurrence was identified. Multivariate Cox-regression analysis showed that gender and cervical lymph node metastasis were significant variables


CONCLUSIONS
PTMC showed very diverse disease extent and could not be regarded as indolent, relatively benign disease based on the primary tumor size. The extent of surgery should be based on prognostic parameters, such as gender and lateral neck node metastasis, in patients with PTMC.
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. tykim@amc.seoul.kr
Tae Yong
TY
Kim
Suck Joon
SJ
Hong
Jung Min
JM
Kim
Won Gu
WG
Kim
Gyungyub
G
Gong
Jin Sook
JS
Ryu
Won Bae
WB
Kim
Sung-Cheol
SC
Yun
Young Kee
YK
Shong
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D013954:Thyroglobulin; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013972:Thyrotropin
D014408:Biomarkers, Tumor; D013972:Thyrotropin; D013954:Thyroglobulin