Papillary thyroid microcarcinoma: clinicopathological characteristics and implications for treatment in 276 patients

Vasileiadis, Ioannis; Karakostas, Efthimios; Charitoudis, Georgios; Stavrianaki, Anna; Kapetanakis, Stylianos; Kouraklis, Gregory; Karatzas, Theodore

doi:10.1111/j.1365-2362.2011.02633.x

Cited by 53 publications

(45 citation statements)

References 27 publications

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“…The multifocality increase the risk of LN metastasis. 35 In present study, CLN metastasis was found to be significantly high when there is multifocality (P=0.003) which detected in 80% of patients, in comparison to patients without multifocality CLN metastasis was detected in 55% of patients.…”

Section: Discussionmentioning

confidence: 77%

“…34 The presence of LN metastasis has been recorded to be 2-6 fold higher in patients with tumors of >4cm in comparison with smaller tumors. 35 In present study, CLN metastasis was more frequent in patients with tumor size >2cm and detected in 77% of patients, in comparison to patients with tumor size ≤2cm CLN metastasis was detected in 53% of patients (P=0.007). Multivariate logistic regression analysis revealed that tumor size >2cm was an independent predictor of CLN metastasis in patients with N0 PTC.…”

Section: Discussionmentioning

confidence: 78%

“…35 In present study, CLN metastasis was found to be significantly high in the presence of bilateral lesions which detected in 89% of patients, in comparison with patients with unilateral tumors CLN metastasis was detected in 52.4% of patients. This difference was statistically significant (P=0.001).…”

Section: Discussionmentioning

confidence: 80%

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Papillary thyroid carcinoma, evaluation of prophylactic central compartment’s dissection versus conservative management: a prospective study

Ali

Abdelhameed

2018

Int Surg J

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INTRODUCTIONPTC is the most common well differentiated thyroid carcinoma (WDTC) and is considered a relatively indolent tumor.1 This relatively benign Behavior has led to a concept that CLND would not affect survival rates.2 Despite this, regional lymph node (LN) metastases are frequent in PTC occurring in 20% to 90% of patients. 3The pattern of LN metastasis takes place in a sequential manner; involving the central compartment (level VI) first with a frequency reaching 90% including micrometastases, followed by the ipsilateral lateral compartment and then the contralateral lateral compartment and the mediastinal LN. 4,5 Although there is consensus of block node dissection in node positive patients there is controversy about the benefits of elective CLND in N0 PTC. 6 Patients have a ABSTRACTBackground: Papillary thyroid carcinoma (PTC) is one of the commonest thyroid cancers. While there is consensus of block node dissection in nodal positive patients, there is controversy in dealing with nodal negative patients regarding the need of block node dissection. We aimed to evaluate prophylactic central lymph node dissection (pCLND) versus conservative management in PTC with N0 neck. Methods:This was a prospective randomized study conducted at General Surgery Department, Sohag University Hospital, from August 2013 to September 2017. It included fifty-five patients diagnosed to have PTC with N0 neck randomly divided into two groups; (Group A) included 25 patients who underwent total thyroidectomy (TT) alone and (Group B) included 30 patients who underwent TT with pCLND. We compared both groups regarding the operative and post-operative outcomes.Results: There was temporary hypoparathyroidism with an incidence of 12% for Group A and 23% for Group B (P=0.01). Permanent hypocalcemia occurred in 1 patient in each group (P=0.75). Unilateral recurrent laryngeal nerve (RLN) temporary palsy occurred in 10% for Group B patients and in 8% for Group A patients, (P=0.46). Node metastases were observed in 43% in group B upstaging the disease. Both univariate and multivariate analyses showed that CLN metastasis was significantly associated with age <45, male gender, tumor size >2.0cm, bilaterality, and multifocality. Locoregional recurrence was observed in 4% of patients in group A and in 0% in B.Conclusions: TT+pCLND is a safe treatment in patients with N0 PTC and it can be done without a high complication rate and without recurrence compared to TT without CLND.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 78%

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Papillary thyroid carcinoma, evaluation of prophylactic central compartment’s dissection versus conservative management: a prospective study

Ali

Abdelhameed

2018

Int Surg J

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“…In general, PTC has a good prognosis with a 5-year survival rate of 97-99% and 10-year survival rate of 98%. 1,9) Similarly, most PTMC have excellent prognosis. However, some studies have shown loco-regional recurrence, distant metastasis, and mortality.…”

Section: Introductionmentioning

confidence: 99%

“…1,2) Papillary thyroid microcarcinoma (PTMC) is defined by the World Health Organization (WHO) as a PTC measuring ≤10 mm in the greatest dimension.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathologic Characteristics of Papillary Microcarcinoma in the Elderly

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et al. 2013

J Korean Thyroid Assoc

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Differences in the characteristics of papillary thyroid microcarcinoma ≤5 mm and >5 mm in diameter

et al. 2014

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Papillary thyroid microcarcinoma: clinicopathological characteristics and implications for treatment in 276 patients

Abstract: Patients presenting multifocal, bilateral PTMC with a maximum diameter > 5 mm and thyroid capsule invasion may have an increased risk of lymph node metastasis. These factors should be considered in the follow-up for these patients.

Cited by 53 publications

References 27 publications

Papillary thyroid carcinoma, evaluation of prophylactic central compartment’s dissection versus conservative management: a prospective study

Papillary thyroid carcinoma, evaluation of prophylactic central compartment’s dissection versus conservative management: a prospective study

Clinicopathologic Characteristics of Papillary Microcarcinoma in the Elderly

Differences in the characteristics of papillary thyroid microcarcinoma ≤5 mm and >5 mm in diameter

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