Identification and optimal postsurgical follow-up of patients with very low-risk papillary thyroid microcarcinomas

Cosimo Durante, Marco Attard, Massimo Torlontano, Giuseppe Ronga, Fabio Monzani, Giuseppe Costante, Marco Ferdeghini, Salvatore Tumino, Domenico Meringolo, Rocco Bruno, Giorgio De Toma, Umberto Crocetti, Teresa Montesano, Angela Dardano, Livia Lamartina, Adele Maniglia, Laura Giacomelli, Sebastiano Filetti

Research output: Contribution to journalArticle

Abstract

Context: Most papillary thyroid microcarcinomas (PTMCs; ≤ 1 cm diameter) are indolent low-risk tumors, but some cases behave more aggressively. Controversies have thus arisen over the optimum postoperative surveillance of PTMC patients. Objectives: We tested the hypothesis that clinical criteria could be used to identify PTMC patients with very low mortality/recurrence risks and attempted to define the best strategy for their management and long-term surveillance. Design: We retrospectively analyzed data from 312 consecutively diagnosed PTMC patients with T1N0M0 stage disease, no family history of thyroid cancer, no history of head-neck irradiation, unifocal PTMC, no extracapsular involvement, and classic papillary histotypes. Additional inclusion criteria were complete follow-up data from surgery to at least 5 yr after diagnosis. All 312 had undergone (near) total thyroidectomy [with radioactive iodine (RAI) remnant ablation in 137 (44%) - RAI group] and were followed up yearly with cervical ultrasonography and serum thyroglobulin, TSH, and thyroglobulin antibody assays. Results: During follow-up (5-23 yr, median 6.7 yr), there were no deaths due to thyroid cancer or reoperations. The first (6-12 months after surgery) and last postoperative cervical sonograms were negative in all cases. Final serum thyroglobulin levels were undetectable (

Original languageEnglish
Pages (from-to)4882-4888
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume95
Issue number11
DOIs
Publication statusPublished - Nov 2010

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

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    Durante, C., Attard, M., Torlontano, M., Ronga, G., Monzani, F., Costante, G., Ferdeghini, M., Tumino, S., Meringolo, D., Bruno, R., De Toma, G., Crocetti, U., Montesano, T., Dardano, A., Lamartina, L., Maniglia, A., Giacomelli, L., & Filetti, S. (2010). Identification and optimal postsurgical follow-up of patients with very low-risk papillary thyroid microcarcinomas. Journal of Clinical Endocrinology and Metabolism, 95(11), 4882-4888. https://doi.org/10.1210/jc.2010-0762