Prognostic value of tumor size and minimal extrathyroidal extension in papillary thyroid carcinoma

Am J Surg. 2020 Oct;220(4):925-931. doi: 10.1016/j.amjsurg.2020.02.020. Epub 2020 Feb 16.

Abstract

Background: Tumour size and extrathyroidal extension (ETE) may impact papillary thyroid carcinoma (PTC) outcomes. We therefore examined the prognostic value of tumour size and ETE for predicting posttreatment recurrence in PTC patients.

Methods: A total of 2,902 patients who underwent thyroidectomy for previously untreated T1-T3 PTC (7th edition American Joint Committee on Cancer) at our tertiary referral center were included. Univariate and multivariate Cox proportional hazard regression analyses were used to determine significant factors predictive of posttreatment recurrence-free survival (RFS).

Results: In univariate analysis, tumour factors (including tumour size, multifocality, ETE, and lymphovascular invasion), nodal factors (including positive lymph node number, lymph node ratio, and extranodal extension), and MACIS (metastases, age, completeness of resection, invasion, and size) scores were significantly associated with RFS outcomes (P < 0.001). In multivariate analysis, tumour size >4 cm (P < 0.001) and multifocality (P = 0.038) were the independent factors of RFS. Nodal factors and MACIS scores were also independent factors of RFS.

Conclusion: Tumour size impacts RFS after thyroidectomy in T1-T3 PTC patients.

Keywords: Extrathyroidal extension; Papillary thyroid carcinoma; Recurrence; Thyroidectomy; Tumor size.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / epidemiology
  • Prognosis
  • Thyroid Cancer, Papillary / epidemiology
  • Thyroid Cancer, Papillary / pathology*
  • Thyroid Cancer, Papillary / surgery
  • Thyroid Neoplasms / epidemiology
  • Thyroid Neoplasms / pathology*
  • Thyroid Neoplasms / surgery
  • Thyroidectomy
  • Tumor Burden