Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2011) 26 P485

Instituto Português de Oncologia de Coimbra FG EPE, Coimbra, Portugal.


Currently there is no widely accepted definition of very low-risk papillary thyroid carcinoma (PTC). Although unifocal microcarcinomas without extrathyroidal extension and no local or distant metastases have been recognized as having an excellent overall prognosis the threshold for such a favourable clinical behaviour remains controversial. The study aim was to identify the clinicopathological characteristics of T1 tumours (≤2 cm) presenting a very low-risk of mortality or recurrence. We retrospectively reviewed the medical data of 258 patients with PTC presenting the following characteristics: T1N0M0 disease, no history of head-neck irradiation, all macroscopic tumour had been resected and the tumour did not have aggressive histological subtype. Periodic follow-up included clinical and ultrasound examination and serum Tg, TSH and antithyroglobulin antibodies measurements. Other imaging modalities were used as required. There were 226 (87.6%) female patients. Mean age at diagnosis was 48.0 years (range, 22–79 years). One hundred ten patients were classified as T1b. The majority of the patients (93.4%) were treated with total or near-total thyroidectomy. Forty-nine patients (18.9%) underwent a variety of cervical lymph node dissections. Radioiodine ablation therapy was administered to 111 patients (43.0%). Patients were followed for a median of 8.2 years after thyroidectomy. Residual/recurrent disease in regional lymph nodes was identified in six patients (2.3%). There was no disease-specific mortality and none of the patients developed distant metastases during follow-up. All patients were considered free of disease at the last follow-up. This study shows that it is possible with a simple set of criteria to accurately identify a subgroup of T1N0M0 PTC patients with very low-risk of recurrence. Our results may suggest that these very low-risk patients may be effectively treated with a conservative management strategy in terms of surgical treatment (extent of thyroidectomy and prophylactic lymph node dissections), radioiodine ablation therapy and levothyroxine therapy.

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