Clinical implications of pathologic factors after thyroid lobectomy in patients with papillary thyroid carcinoma

• Published in: Oral oncology Vol. 75; pp. 1 - 5
• Main Authors: Park, Young Min, Lee, Doh Young, Oh, Kyung Ho, Cho, Jae-Gu, Baek, Seung-Kuk, Kwon, Soon-Young, Jung, Kwang-Yoon, Woo, Jeong-Soo
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-12-2017
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Carcinoma, Papillary - pathology; Carcinoma, Papillary - surgery; Female; Humans; Male; Microscopic extrathyroidal extension; Middle Aged; Neoplasm Invasiveness; Papillary thyroid carcinoma; Pathologic factor; Recurrence; Retrospective Studies; Survival Analysis; Thyroid Cancer, Papillary; Thyroid lobectomy; Thyroid Neoplasms - pathology; Thyroid Neoplasms - surgery; Thyroidectomy - methods; Tumor Burden; Young Adult; Microscopic extrathyroidal extension; Recurrence; Pathologic factor; Papillary thyroid carcinoma; Thyroid lobectomy
• ISSN: 1368-8375; 1879-0593
• DOI: 10.1016/j.oraloncology.2017.10.012

•micro-ETE was an important prognostic factor associated with RFS.•The 10-year RFS was 99.2% for patients without ETE.•The 10-year RFS was 92.2% for patients with micro-ETE.•Appropriate US follow-up should be required in patients with the risk factors.
We evaluated the clinical and prognostic significance of pathologic factors by analyzing the treatment results of patients who underwent thyroid lobectomy.
We retrospectively analyzed data from 734 patients diagnosed with papillary thyroid cancer who underwent thyroid lobectomy at Korea University Hospital from January 2004 to December 2016.
A total of 734 patients were included in the study and their mean age was 44.5 years (range, 15–83). On univariate analysis, tumor size and recurrence-free survival were significantly related. The 10-year recurrence-free survival was 98.3% for tumors ≤1cm, 77.8% for >1cm and ≤2cm, and 66.7% for >2cm (p = 0.014). Recurrence-free survival was significantly different between patients with and without microscopic extrathyroidal extension (p=0.002). The 10-year recurrence-free survival rate was 99.2% for patients without extrathyroidal extension and 92.2% for patients with microscopic extrathyroidal extension. Multivariate analysis showed only microscopic extrathyroidal extension was significantly correlated with recurrence-free survival (p=0.029).
In patients undergoing thyroid lobectomy for low-risk papillary thyroid cancer, microscopic extrathyroidal extension was an important prognostic factor associated with recurrence-free survival. However, in cases with microscopic extrathyroidal extension findings on postoperative pathologic examination, appropriate ultrasonographic follow-up of the contralateral thyroid lobe and cervical lymph node to facilitate early detection and prompt treatment of recurrence can control the disease without a deterioration of survival rate.