Clinical significance of residual occult malignancy in thyroid carcinoma

Turanlı, Sevim; Aslan, Sabahattin; Çetin, Abdullah

doi:10.1016/j.amjoto.2009.12.005

Cited by 15 publications

(11 citation statements)

References 18 publications

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“…Additionally, complete surgery improves the patient outcome and makes follow-up with serum Tg and RAI scanning more reliable [6,7]. In previous studies, the rate of tumor detection in residual tissue after completion thyroidectomy has been reported between 20-77% [8][9][10][11][12]. In the present study, 22.4% of the patients had tumor in the residual tissue.…”

Section: Methodssupporting

confidence: 58%

“…Similarly, in another study [17], multifocality was a significant predictor of tumor presence in the residual tissue with a rate of 57.7%. Age, gender, tumor histology, tumor size, thyroid capsular invasion, vascular invasion, and categorized serum Tg levels (Tg <2ng/mL, 2-10 ng/mL, and >10 ng/mL) were not significant predictive factors in that study.…”

Section: Methodsmentioning

confidence: 63%

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Predictive Factors of Malignancy in Residual Thyroid Tissue after Partial Thyroidectomy in Patients with Differentiated Thyroid Cancer

Gökay¹,

Berker²,

Arduç³

et al. 2015

Med-Science

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Section: Methodssupporting

confidence: 58%

Section: Methodsmentioning

confidence: 63%

Predictive Factors of Malignancy in Residual Thyroid Tissue after Partial Thyroidectomy in Patients with Differentiated Thyroid Cancer

Gökay¹,

Berker²,

Arduç³

et al. 2015

Med-Science

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“…[6,7] Studies have shown that unilateral multifocality of the primary tumor and the presence of a coexistent benign nodule in the contralateral lobe by preoperative evaluation were independent predictive factors for occult contralateral PTC. [8,9,11,12] Wu et al [11] performed total thyroidectomy in 347 patients with unilateral papillary microcarcinoma combined with coexistent nodules in the contralateral lobe, and occult contralateral PTC was observed in 28.9%. Multivariate analysis showed that unilateral multifocality, presence of coexistent benign nodules in the contralateral lobe, and maximum tumor diameter greater than 5 mm were independent predictive factors of contralateral occult carcinoma, total thyroidectomy was thus suggested for patients with unilateral papillary microcarcinoma if they had any of the following factors: maximum tumor diameter greater than 5 mm, unilateral multifocality, or the presence of coexistent nodules in the contralateral lobe.…”

Section: Discussionmentioning

confidence: 99%

“…Turanli et al [9] found that 20.6% of patients with unilateral carcinoma also had contralateral occult carcinoma and unilateral multifocality was an independent predictive factor of occult carcinoma. However, contralateral occult carcinoma had no effect on survival and thus the authors suggested that total thyroidectomy was not mandatory for all patients.…”

Section: Discussionmentioning

confidence: 99%

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Long-term outcome of thyroid lobectomy for unilateral multifocal papillary carcinoma

Huang

Liu

et al. 2017

Medicine

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The National Comprehensive Cancer Network (NCCN) guidelines recommend completion thyroidectomy for patients with multifocal papillary thyroid carcinoma (PTC) diagnosed by paraffin pathology after lobectomy. However, studies for the influence of surgical range on prognosis of unilateral multifocal carcinoma are scarce. We analyzed the clinicopathological characteristics and long-term outcomes of patients with unilateral multifocal PTC to identify risk factors for recurrence and disease-related death.The clinical and pathological data of 123 cases with multifocal lesions in the unilateral thyroid lobe were retrospectively collected, including sex, age, stage, surgical range, histopathology characteristics, and follow-up data. The prognostic factors were analyzed by means of the Kaplan–Meier method.The recurrence in the contralateral residual thyroid was observed in 6 cases. The 10-year cumulative recurrence rate of the remnant thyroid was 7.0%. Extrathyroidal extension (ETE) was a significant prognostic factor, with χ2 equal to 4.043 and a P value of .044. One patient died from progression of pulmonary metastasis during the follow-up. The 10-year disease-specific survival rate was 96% and 14 cases experienced recurrences and underwent a second surgery (11.4%), and thus the 10-year recurrence-free survival rate was 83.2%. Multivariate analysis showed that the pathologic tumor (pT) stage was an independent prognostic factor for the recurrence-free survival rate (P <.0001, hazard ratio 2.871, 95% confidence interval 1.783–4.624).ETE is a significant prognostic factor for the recurrence of the remnant thyroid and pT stage is an independent prognostic factor for tumor recurrence-free survival. Lobectomy (with isthmectomy) is effective for most patients with unilateral multifocal PTC.

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Recurrence following hemithyroidectomy in patients with low- and intermediate-risk papillary thyroid carcinoma

Ahn

Lee

Sohn

2020

British Journal of Surgery

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Background: This study evaluated the incidence, patterns and risk factors for recurrence after hemithyroidectomy in patients with low-and intermediate-risk papillary thyroid carcinoma (PTC), and verified the predictive role of the risk staging systems in current use. Methods: The clinicopathological characteristics and risk categories were analysed according to recurrence in patients who underwent hemithyroidectomy for low-and intermediate-risk conventional PTC, and were followed up for at least 24 months. Five risk staging systems were used to stratify risk: the 2015 American Thyroid Association (ATA) system; Age, Metastases, Extent and Size (AMES) system; Metastases, Age, Complete resection, Invasion and Size (MACIS) system; Grade, Age, Metastases, Extent and Size (GAMES) system; and the eighth AJCC system. Results: The study included 561 patients; 93⋅9 per cent of the study population (527 of 561) had a papillary thyroid microcarcinoma 1 cm or smaller in size. At a mean follow-up of 83 months, 25 patients (4⋅5 per cent) had recurrence; among these patients, 23 (92%) presented with a remaining thyroid lobe. Multifocality was significantly associated with recurrence in univariable and multivariable analyses (adjusted hazard ratio 3⋅16, 95 per cent c.i. 1⋅25 to 7⋅98; P = 0⋅015). Disease-free survival (DFS) varied according to multifocality (P = 0⋅010). The five risk staging systems were not associated with recurrence, and their Harrell's C-index ranged from 0⋅500 to 0⋅531. DFS rates did not differ between the risk categories in each system. Conclusion:Although the recurrence rate after hemithyroidectomy in patients with low-and intermediate-risk PTC was low, meticulous follow-up focusing on the remaining thyroid lobe is needed for early detection and timely management of recurrence. The risk scoring systems in current use have no predictive role in these patients.

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Clinical significance of residual occult malignancy in thyroid carcinoma

Cited by 15 publications

References 18 publications

Predictive Factors of Malignancy in Residual Thyroid Tissue after Partial Thyroidectomy in Patients with Differentiated Thyroid Cancer

Predictive Factors of Malignancy in Residual Thyroid Tissue after Partial Thyroidectomy in Patients with Differentiated Thyroid Cancer

Long-term outcome of thyroid lobectomy for unilateral multifocal papillary carcinoma

Recurrence following hemithyroidectomy in patients with low- and intermediate-risk papillary thyroid carcinoma

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