Papillary Carcinoma of the Thyroid

Abstract

Between 1954 and 1993 503 patients with papillary carcinoma of the thyroid were treated at the Department of Otolaryngology–Head and Neck Surgery of the Beilinson Medical Center. Two thirds of these patients were women. The median follow-up period was 10.3 years. In more than 30% of cases the tumor was discovered because of the presence of an enlarged lymph node and/or invasion to adjacent structures. Total or near-total thyroidectomy was performed in 381 patients. The 48 patients in whom it was necessary to perform a reoperation had a significantly higher complication rate. Multicentricity was found in 65% of those cases in which both thyroid lobes were available for histologic examination. Nineteen patients were found to have a “tail” cell variant, 223 had a pure papillary variant, and 261 a follicular variant. The mortality rate was 6.2% 15 years after Initial therapy. A number of factors–age, size of tumor, presence of distant metastases, “tall” cell variant, and type of surgery–were found to be significant predictors of survival. After almost 40 years of experience in treating more than 500 cases of papillary cancer, we have come to the conclusion that the surgical approach should be aggressive.

Central Lymph Node Dissection in Differentiated Thyroid Cancer

“…One prospective cohort study (level III according to Sackett's modified classification; Table 1) provides the best available data (Table 4); 32 a retrospective cohort study (level IV) also exists (Table 4). 45 Three case series (level V) have also attempted to address this topic (Table 4). [46][47][48] The Du ¨sseldorf Study from Germany…”

“…The Tel Aviv study 45 retrospectively reviewed 503 patients with PTC. After a follow-up ranging from 1 to 20 years, 48 patients with recurrent thyroid cancer underwent reoperation.…”

An Evidence‐based Approach to Familial Nonmedullary Thyroid Cancer: Screening, Clinical Management, and Follow‐up

“…An increased incidence of multifocality, extrathyroidal disease, and local invasion in patients with FNMTC compared to other patients with papillary thyroid cancer has been reported. 2,8,20,[27][28][29] Local invasion is sometimes associated with pain, vocal hoarseness, dysphagia, odynophagia, or dyspnea. However, to our knowledge no studies to date have documented any increase in these symptoms in patients with FNMTC.…”

“…Most case reports/series find the mean age of diagnosis for patients with FNMTC to be similar to those with sporadic NMTC, [7][8][9]17,41 but there are some that have noted a slightly earlier presentation, as occurs in most familial syndromes. 13,21,25,32 A meta-analysis found that patients with FNMTC presented up to a decade earlier than their sporadic counterparts, 27,29 with a peak age of onset in FNMTC patients of the fourth decade. 2 An interesting finding in an FNMTC case series by Musholt et al 25 was the similar age at the time of diagnosis among affected members.…”

Tall Cell Variant: An Aggressive Form of Papillary Thyroid Carcinoma

“…1 Approximately 162 cases of the TCV were reported in the literature before this study. [2][3][4][5][6][7][8][9][10][11][12] One hundred forty-three of 162 patients have adequate follow-up to assess tumor recurrence and cancer-related mortality.…”