Impact of Degree of Extrathyroidal Extension of Disease on Papillary Thyroid Cancer Outcome

Abstract

Oncological outcome correlates with the extent of extrathyroidal invasion. Outcome is worse in patients with gross extrathyroidal disease extension than in those with microscopic local invasion apparent on histopathological assessment. However, the risk of clinical recurrence appears similar between patients undergoing margin-negative and "close margin" resection.

Meta-Analyses of Association Between BRAFV600E Mutation and Clinicopathological Features of Papillary Thyroid Carcinoma

“…Some studies have indicated that PTC patients with minimal or microscopic extension had worse prognostic outcomes than those with maximal or macroscopic extension [106][107][108]. However, ETE or microscopic local invasion is inconsistently defined and utilized among studies and there are a large number of studies which did not concern about various degrees of extrathyroidal extension.…”

Characteristics and significance of minimal and maximal extrathyroidal extension in papillary thyroid carcinoma

“…However, in recent studies attempts have been made to compare microscopic and macroscopic ETE, or absence of ETE and minimal and maximal ETE [2,15,18]. In other studies, ETE has been classified into four groups: with a negative margin versus a close margin, microscopic ETE, and gross ETE [14,15]. In yet another study, ETE was divided into the four groups, absence of ETE, minimal ETE, maximal ETE which could be shaved off, and maximal ETE that had invaded the recurrent laryngeal nerve, trachea and/or esophagus [21].…”

“…It has been reported that the outcome of macroscopic gross ETE was worse than that of microscopic local invasion [14][15][16][17]. However, in the previous studies the definition of ETE was neither clear nor constant.…”

Reappraisal of the indication for radioiodine thyroid ablation in differentiated thyroid cancer patients

“…The clinical importance of minimal extrathyroidal extension on outcome of PTC is not well established. However, several recent studies reported no significant difference in recurrence or recurrence-free survival between patients with and without minimal extrathyroidal invasion [11][12][13]. Nixon et al [12] reported no significant difference in 10-year OS, DSS or RFS between the pT1/pT2 and pT3 groups (OS: 93 vs. 88 %, p = 0.129; DSS: 99 vs. 100 %, p = 0.733; RFS: 98 vs. 95 %, p = 0.188, respectively).…”

“…In their meta-analysis, Sacks et al [8] concluded that 131 I remnant ablation did not improve survival or recurrence in patients aged <45 years with microscopic central compartment lymph node metastases, whereas benefit was uncertain in the setting of lateral or macroscopic lymph node metastases. More recently, some studies in which only intermediate-risk patients were evaluated, have been published [9][10][11][12][13][14]. Aggressive variant of PTC, such as diffuse sclerosing (DSV) and tall cell (TCV) variants, has a worse prognosis than classic PTC variant [9,10].…”