Prognostic factors affecting neck lymph node recurrence and distant metastasis in papillary microcarcinoma of the thyroid: Results of a study in 445 patients

Giuseppe Mercante, Andrea Frasoldati, Corrado Pedroni, Debora Formisano, Luigi Renna, Simonetta Piana, Giorgio Gardini, Roberto Valcavi, Verter Barbieri

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Abstract

Background: The management of thyroid papillary microcarcinoma (PMC) is controversial. Total thyroidectomy, thyroid lobectomy/isthmectomy, and even no treatment have been proposed. We investigated the clinical course and prognostic factors for disease recurrence and distant metastasis in 445 patients with PMC. Methods: Data from 445 patients diagnosed with PMC in the period from 1978 to 2003 were reviewed and analyzed. Total thyroidectomy was performed in 404 patients and loboisthmusectomy in 41. Neck dissection took place in 226 patients (49.7%), with 166 of only the central compartment and 60 of both the central and lateral compartments. Radioiodine (131I) ablation treatment was given to 389 patients. Results: Median tumor size was 7mm (range 1-10mm). PMC was multifocal in 156 cases (35%) and bilateral in 60 cases (13.5%). Extrathyroidal tumor extension (pT3) and neck lymph node metastasis (pN1) were present in 133 (30%) and 182 (40.9%) patients, respectively. Capsular invasion without extrathyroidal tumor extension was observed in 39 (8.7%) patients. Mean follow-up was 5.3 (range 1-26) years. Seventeen (3.8%) patients had recurrence or persistence of disease: neck recurrence (NR) in 12 (2.7%), distant metastasis (DM) in four (0.9%), NR+DM in one (0.2%). One patient (0.2%) died of the disease. Capsular invasion, extrathyroidal tumor extension (pT3), and neck lymph node metastasis at presentation (pN1) were the only independent risk factors for NR and/or DM occurrence (p

Original languageEnglish
Pages (from-to)707-716
Number of pages10
JournalThyroid
Volume19
Issue number7
DOIs
Publication statusPublished - Jul 1 2009

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Neck
Lymph Nodes
Neoplasm Metastasis
Recurrence
Thyroidectomy
Neoplasms
Papillary Thyroid Microcarcinoma
Neck Dissection
Thyroid Gland
Therapeutics

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

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Prognostic factors affecting neck lymph node recurrence and distant metastasis in papillary microcarcinoma of the thyroid : Results of a study in 445 patients. / Mercante, Giuseppe; Frasoldati, Andrea; Pedroni, Corrado; Formisano, Debora; Renna, Luigi; Piana, Simonetta; Gardini, Giorgio; Valcavi, Roberto; Barbieri, Verter.

In: Thyroid, Vol. 19, No. 7, 01.07.2009, p. 707-716.

Research output: Contribution to journalArticle

Mercante, Giuseppe ; Frasoldati, Andrea ; Pedroni, Corrado ; Formisano, Debora ; Renna, Luigi ; Piana, Simonetta ; Gardini, Giorgio ; Valcavi, Roberto ; Barbieri, Verter. / Prognostic factors affecting neck lymph node recurrence and distant metastasis in papillary microcarcinoma of the thyroid : Results of a study in 445 patients. In: Thyroid. 2009 ; Vol. 19, No. 7. pp. 707-716.
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abstract = "Background: The management of thyroid papillary microcarcinoma (PMC) is controversial. Total thyroidectomy, thyroid lobectomy/isthmectomy, and even no treatment have been proposed. We investigated the clinical course and prognostic factors for disease recurrence and distant metastasis in 445 patients with PMC. Methods: Data from 445 patients diagnosed with PMC in the period from 1978 to 2003 were reviewed and analyzed. Total thyroidectomy was performed in 404 patients and loboisthmusectomy in 41. Neck dissection took place in 226 patients (49.7{\%}), with 166 of only the central compartment and 60 of both the central and lateral compartments. Radioiodine (131I) ablation treatment was given to 389 patients. Results: Median tumor size was 7mm (range 1-10mm). PMC was multifocal in 156 cases (35{\%}) and bilateral in 60 cases (13.5{\%}). Extrathyroidal tumor extension (pT3) and neck lymph node metastasis (pN1) were present in 133 (30{\%}) and 182 (40.9{\%}) patients, respectively. Capsular invasion without extrathyroidal tumor extension was observed in 39 (8.7{\%}) patients. Mean follow-up was 5.3 (range 1-26) years. Seventeen (3.8{\%}) patients had recurrence or persistence of disease: neck recurrence (NR) in 12 (2.7{\%}), distant metastasis (DM) in four (0.9{\%}), NR+DM in one (0.2{\%}). One patient (0.2{\%}) died of the disease. Capsular invasion, extrathyroidal tumor extension (pT3), and neck lymph node metastasis at presentation (pN1) were the only independent risk factors for NR and/or DM occurrence (p",
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AU - Frasoldati, Andrea

AU - Pedroni, Corrado

AU - Formisano, Debora

AU - Renna, Luigi

AU - Piana, Simonetta

AU - Gardini, Giorgio

AU - Valcavi, Roberto

AU - Barbieri, Verter

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N2 - Background: The management of thyroid papillary microcarcinoma (PMC) is controversial. Total thyroidectomy, thyroid lobectomy/isthmectomy, and even no treatment have been proposed. We investigated the clinical course and prognostic factors for disease recurrence and distant metastasis in 445 patients with PMC. Methods: Data from 445 patients diagnosed with PMC in the period from 1978 to 2003 were reviewed and analyzed. Total thyroidectomy was performed in 404 patients and loboisthmusectomy in 41. Neck dissection took place in 226 patients (49.7%), with 166 of only the central compartment and 60 of both the central and lateral compartments. Radioiodine (131I) ablation treatment was given to 389 patients. Results: Median tumor size was 7mm (range 1-10mm). PMC was multifocal in 156 cases (35%) and bilateral in 60 cases (13.5%). Extrathyroidal tumor extension (pT3) and neck lymph node metastasis (pN1) were present in 133 (30%) and 182 (40.9%) patients, respectively. Capsular invasion without extrathyroidal tumor extension was observed in 39 (8.7%) patients. Mean follow-up was 5.3 (range 1-26) years. Seventeen (3.8%) patients had recurrence or persistence of disease: neck recurrence (NR) in 12 (2.7%), distant metastasis (DM) in four (0.9%), NR+DM in one (0.2%). One patient (0.2%) died of the disease. Capsular invasion, extrathyroidal tumor extension (pT3), and neck lymph node metastasis at presentation (pN1) were the only independent risk factors for NR and/or DM occurrence (p

AB - Background: The management of thyroid papillary microcarcinoma (PMC) is controversial. Total thyroidectomy, thyroid lobectomy/isthmectomy, and even no treatment have been proposed. We investigated the clinical course and prognostic factors for disease recurrence and distant metastasis in 445 patients with PMC. Methods: Data from 445 patients diagnosed with PMC in the period from 1978 to 2003 were reviewed and analyzed. Total thyroidectomy was performed in 404 patients and loboisthmusectomy in 41. Neck dissection took place in 226 patients (49.7%), with 166 of only the central compartment and 60 of both the central and lateral compartments. Radioiodine (131I) ablation treatment was given to 389 patients. Results: Median tumor size was 7mm (range 1-10mm). PMC was multifocal in 156 cases (35%) and bilateral in 60 cases (13.5%). Extrathyroidal tumor extension (pT3) and neck lymph node metastasis (pN1) were present in 133 (30%) and 182 (40.9%) patients, respectively. Capsular invasion without extrathyroidal tumor extension was observed in 39 (8.7%) patients. Mean follow-up was 5.3 (range 1-26) years. Seventeen (3.8%) patients had recurrence or persistence of disease: neck recurrence (NR) in 12 (2.7%), distant metastasis (DM) in four (0.9%), NR+DM in one (0.2%). One patient (0.2%) died of the disease. Capsular invasion, extrathyroidal tumor extension (pT3), and neck lymph node metastasis at presentation (pN1) were the only independent risk factors for NR and/or DM occurrence (p

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