title: The surgical management of papillary thyroid microcarcinoma: a 162-month single-center experience of 273 cases.
abstract: The aim of this study was to evaluate outcomes for patients with papillary thyroid microcarcinoma (PTMC) treated at a single institution during a 162-month period and to determine which patients need aggressive treatment. Two hundred seventy-three patients with PTMC had subtotal or  total thyroidectomy + prophylactic or therapeutic lymph node dissection. Clinical and histopathological characteristics of 273 patients were identified and statistically analyzed. The tumors were multifocal in 36.3 per cent of the patients with PTMCs. Fifty-six per cent had neck lymph node  metastases at diagnosis. Large-sized tumor (over 5 mm), age older than 45 years, multifocality, bilaterality, and extrathyroidal extension were associated with subclinical central lymph node metastases. Ninety-six patients older than 45 years of age were upgraded from Stage I to III or IVA.  Ten patients with lateral node recurrence or local recurrence in the residual thyroid had one or more risk factors. The high rates of multifocality and Level VI area subclinical lymph node metastasis were two important clinical and histopathological characteristics of PTMC. Patients who had  one or more risk factors should receive more aggressive surgical management.
authors.affiliation: Department of Thyroid and Breast Surgery, Jinan Military General Hospital of PLA, Jinan, People's Republic of China. heqingqing@yeah.net
authors.forename: Qingqing
authors.initials: Q
authors.lastname: He
authors.forename: Dayong
authors.initials: D
authors.lastname: Zhuang
authors.forename: Luming
authors.initials: L
authors.lastname: Zheng
authors.forename: Ziyi
authors.initials: Z
authors.lastname: Fan
authors.forename: Peng
authors.initials: P
authors.lastname: Zhou
authors.forename: Zhen
authors.initials: Z
authors.lastname: Lv
authors.forename: Jixin
authors.initials: J
authors.lastname: Chai
authors.forename: Songjian
authors.initials: S
authors.lastname: Duan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000601:surgery*; D002291:Carcinoma, Papillary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy; D055815:Young Adult