Small papillary thyroid carcinoma with minimal extrathyroidal extension should be managed as ATA low-risk tumor

Journal of Endocrinological Investigation
M G CastagnaF Pacini

Abstract

According to American Thyroid Association (ATA) guideline, papillary thyroid cancer (PTC) with minimal extrathyroidal extension (mETE) is classified at "intermediate risk" of persistent/recurrent disease. However, the impact of mETE per se on patients' outcome is not fully understood. The aim of our study was to evaluate the prognostic significance of mETE in patients with PTC not submitted to therapeutic or prophylactic lymph node dissection, according to tumor size and other prognostic factors. We retrospectively evaluated a total of 514 PTC patients: 127 (24.7%) had mETE (pT3Nx) and 387 (75.3%) had negative margins (pT1-2Nx). At a median follow-up of 9.1 years, patients were divided in two groups: patients with "good outcome" (no evidence of disease) and patients with "poor outcome" (persistent structural disease or recurrent disease or tumor-related death). The rate of patients with "poor outcome" was significantly higher in patients with mETE compared with patients with negative margins (11.8 versus 5.1%; OR 2.4576, 95% CI 1.2178-4.9594, p = 0.01). However, mETE was significantly associated with poor outcome only in patients with tumors larger than 1.5 cm. mETE is an unfavorable prognostic factor in tumors larger than 1.5 ...Continue Reading

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Citations

Oct 4, 2018·Frontiers in Endocrinology·Claudio CasellaNazario Portolani
Mar 31, 2019·Journal of Endocrinological Investigation·M CapezzoneM G Castagna
Feb 16, 2020·Thyroid : Official Journal of the American Thyroid Association·Debora L S DanilovicSuemi Marui
Apr 19, 2018·Journal of Endocrinological Investigation·G GraniM Maranghi
May 11, 2019·International Journal of Endocrinology·Jun Jiang, Hui Lu
Nov 13, 2020·Expert Review of Anticancer Therapy·Michael Y GuoSam M Wiseman
Sep 21, 2021·Thyroid : Official Journal of the American Thyroid Association·Raffaella ForleoMaria Grazia Castagna
Mar 28, 2021·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Robert SeifertBenjamin Noto

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