The impact of minimal extrathyroidal extension in the recurrence of papillary thyroid cancer patients

ABSTRACT Objective We aimed to evaluate the impact of minimal extrathyroidal extension (mETE) alone on the risk of recurrence of papillary thyroid carcinoma (PTC). The impact of other factors, including multifocality, age, tumor size, and stimulated thyroglobulin (sTg) values was also assessed. Subj...

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Published in:	Archives of Endocrinology and Metabolism Vol. 64; no. 3; pp. 251 - 256
Main Authors:	Almeida, Maria Fernanda Ozorio de, Couto, Júlia Soares, Ticly, Ana Luiza Trevizani, Guardia, Vivian Cenize, Marone, Marilia Martins Silveira, Scalissi, Nilza Maria, Cury, Adriano Namo, Ferraz, Carolina, Padovani, Rosália do Prado
Format:	Journal Article
Language:	English
Published:	Sociedade Brasileira de Endocrinologia e Metabologia 01-05-2020 Brazilian Society of Endocrinology and Metabolism
Subjects:	carcinoma extension Differentiated thyroid cancer minimal extrathyroidal extension Original prognosis
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Summary:	ABSTRACT Objective We aimed to evaluate the impact of minimal extrathyroidal extension (mETE) alone on the risk of recurrence of papillary thyroid carcinoma (PTC). The impact of other factors, including multifocality, age, tumor size, and stimulated thyroglobulin (sTg) values was also assessed. Subjects and methods We retrospectively analyzed 1,108 PTC patients from a medical institution, who presented tumors ≤ 4 cm without any adverse characteristics other than mETE. Patients were classified according to their response to initial treatment 12 to 24 months after surgery as proposed by the 2015 American Thyroid Association (ATA) guideline. Statistical analysis was performed using multivariate logistic regression and receiver operating characteristic (ROC) curve. Results In the multivariate logistic regression analysis, mETE did not have an impact on the response to initial treatment (p = 0.44), similar to multifocality, age, and tumor size. Initial Tg value was the only variable associated with a poor response (p < 0.01, odds ratio = 1.303, 95% confidence interval 1.25-1.36). The ROC analysis revealed that Tg was significant (area under curve = 0.8750); the cutoff value of sTg as a predictor of poor response was 10 ng/mL (sensitivity = 72.2%, specificity = 98.5%). Conclusion For low-risk PTC presenting mETE as the only aggressive feature, the initial sTg value is essential to identify patients who may have a poor response after initial treatment and benefit from further treatment. Arch Endocrinol Metab. 2020;64(3):251-6
Bibliography:	Disclosure: no potential conflict of interest relevant to this article was reported.
ISSN:	2359-3997 2359-4292
DOI:	10.20945/2359-3997000000245