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Minerva Endocrinologica 2015 March;40(1):15-22

lingua: Inglese

A retrospective analysis of prognostic factors predictive of lymph­node metastasis and recurrence in thyroid papillary microcarcinoma

Usluogullari C. A. 1, Onal E. D. 1, Ozdemir E. 2, Ucler R. 1, Kiyak G. 3, Ersoy P. E. 3, Yalcin S. 3, Güler G. 3, Ersoy R. 1, Cakir B. 1

1 Department of Endocrinology and Metabolism, Yildirim Beyazit University, Ataturk Training and Research Hospital, Ankara, Turkey;
2 Department of Nuclear Medicine, Yildirim Beyazit University, Ataturk Training and Research Hospital, Ankara, Turkey;
3 Department of General Surgery, Yildirim Beyazit University, Ataturk Training and Research Hospital, Ankara, Turkey


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AIM: The literature is inconclusive concerning the prognostic factors and therapeutic management of papillary thyroid microcarcinoma (PTMC). Herein we report on our extensive experience with PTMC in relation to clinicopathological characteristics and prognostic factors.
METHODS: In all, 248 patients that were diagnosed and treated for PTMC between 2007 and 2012 were retrospectively analyzed. Demographic and tumor characteristics at presentation, and recurrence during follow-up were noted.
RESULTS: Total thyroidectomy and radioactive iodine (RAI) ablation treatment were performed in all patients. Bilateral involvement, vascular and capsular invasion, extra-thyroidal extension, and lymph node metastasis occurred significantly more frequently in patients with tumor size >5 mm (P<0.05). Multivariate statistical analysis showed that a clinically suspected diagnosis (OR:0.095; P=0.043) and elevated thyroglobulin (TG) level (OR: 1.083; P=0.011; cut-off value ≥7.98 ngmL–1) were significant and independent risk factors for lymph node metastasis, with a sensitivity of 57% and specificity of 83%. After a median follow-up of 2 years (range:0.3-11 years), 10 (4%) of the 248 patients had recurrent disease. According to multivariate analysis, lymph node metastasis (OR: 51.4; P=0.003) was the only independent predictor of recurrence.
CONCLUSION: Our findings revealed that serum TG level and a clinically suspected diagnosis were risk factors for lymph node metastasis, while nodal metastasis was a predictor of recurrence.

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calperuslu@yahoo.com