Impact of microscopic extra-nodal extension (ENE) on locoregional recurrence following curative surgery for papillary thyroid carcinoma

Journal of Surgical Oncology
Brian H-H LangKoon Yat Wan

Abstract

The presence of microscopic extra-nodal extension (ENE) may increase locoregional recurrence (LRR) in papillary thyroid carcinoma (PTC). We aimed to evaluate the association between microscopic ENE, response to initial therapy and LRR risk following total thyroidectomy, therapeutic neck dissection, and radioactive iodine (RAI) ablation in PTC. Of the 369 eligible PTC patients, 264 (71.5%) did not have microscopic ENE (group I) while 105 (28.5%) did (group II). All presented with clinical nodal metastasis (cN1) and underwent therapeutic neck dissection and RAI ablation. Biochemical incompleteness meant post-ablation stimulated thyroglobulin (sTg) >10 ng/ml. Multivariate analyses were conducted to identify independent factors for LRR. Biochemical incompleteness was significantly more common group II (43.8% vs. 17.4%, P < 0.05). The 10-year locoregional free-survival was significantly worse in group II than I (52.0% vs. 86.2%, P = 0.005). After adjusting for other significant factors, age <45 (P < 0.05), multifocality (P < 0.05), presence of ENE (P = 0.027) were independent risk factors of LRR. The number and size of positive lymph nodes were not independent factors. Patients with microscopic ENE were significantly more likely to ...Continue Reading

References

May 27, 2006·European Journal of Endocrinology·Furio PaciniUNKNOWN European Thyroid Cancer Taskforce
Nov 28, 2009·Arquivos brasileiros de endocrinologia e metabologia·Fabián PitoiaHugo Niepomniszcze
Oct 23, 2012·Thyroid : Official Journal of the American Thyroid Association·Gregory W RandolphUNKNOWN American Thyroid Association Surgical Affairs Committee’s Taskforce on Thyroid Cancer Nodal Surgery
Jan 22, 2014·Thyroid : Official Journal of the American Thyroid Association·Jason B ClainMark L Urken

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Citations

Sep 4, 2017·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Suvi RenkonenKatri Aro
Jul 22, 2021·Cancer Management and Research·Seung Taek LimYoung Jin Suh

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