title: Therapeutic Strategies and Clinical Outcome in Papillary Thyroid Microcarcinoma: A Multicenter Observational Study.
abstract: OBJECTIVE
  Papillary thyroid microcarcinoma (MPTC) has an excellent prognosis. We aimed to evaluate the evolution of therapeutic strategies over time and the clinical outcome of MPTC.
  
  
  METHODS
  In this retrospective multicenter observational study in a northwest Italian region, patients with intrathyroidal, unifocal tumor ≤1 cm in size, incidentally found at histology or preoperative cytology diagnosis, were included. Exclusion criteria were a previous head-and-neck irradiation and/or node metastases.
  
  
  RESULTS
  From 1985 to 2012, 437 patients had an MPTC diagnosis, which was incidental in 85% and preoperative in 15%. Patients with a preoperative diagnosis were younger at the time of diagnosis (47.6 ± 12.7 years, p < 0.01) and had a larger tumor (7.0 ± 2.5 mm, p < 0.0001) than patients with an incidental diagnosis (age 52 ± 13.5 years, size 4.4 ± 2.8 mm), but there were no differences in clinical outcome between both groups. We observed a significant (p < 0.001) reduction in radioiodine remnant ablation during the years. TSH levels were: <0.1 mIU/l in 27.5%, 0.1-0.5 mlU/l in 33.7%, 0.5-2.5 mlU/l in 32.6%, 2.5-4.2 mlU/l in 3.9%, and >4.2 mlU/l in 2.3% of patients. Six patients (1.37%) had nodal recurrence; 5 of them were cured after therapy. MPTC-linked mortality was null.
  
  
  CONCLUSIONS
  We confirmed the favorable clinical outcome of MPTC. Despite the reduction in radioiodine ablation, overtreatment of MPTC is still observed.
authors.affiliation: Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Cecoli
authors.affiliation: Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa, Italy.
authors.forename: E M
authors.initials: EM
authors.lastname: Ceresola
authors.affiliation: Endocrinology and Nuclear Medicine, Galliera Hospital, Genoa, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Altrinetti
authors.affiliation: Endocrinology and Nuclear Medicine, Galliera Hospital, Genoa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Cabria
authors.affiliation: Endocrine Unit, Sant'Andrea Hospital, La Spezia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Cappagli
authors.affiliation: Endocrine Unit, Sant'Andrea Hospital, La Spezia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Montepagani
authors.affiliation: Endocrinology and Nuclear Medicine, Galliera Hospital, Genoa, Italy.
authors.forename: C M
authors.initials: CM
authors.lastname: Cuttica
authors.affiliation: Evangelico Internazionale Hospital, Genoa, Italy.
authors.forename: U
authors.initials: U
authors.lastname: Filippi
authors.affiliation: Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Saverino
authors.affiliation: Endocrine-Metabolic Center, ASL 1, Imperia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Raffa
authors.affiliation: Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Caputo
authors.affiliation: Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Minuto
authors.affiliation: Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Giusti
authors.affiliation: Endocrinology, Nuclear Medicine and Autoimmunity Laboratory, Department of Internal Medicine, and Department of Experimental Medicine, Genoa University, and IRCCS Azienda Ospedaliera Universitaria San Martino - IST Genoa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bagnasco
keywords: Clinical outcome; Papillary thyroid microcarcinoma; Prognosis; Therapeutic approach