Treatment, follow up and prognostic factors of papillary microcarcinoma

Alper Celil Usluogullari; Eda Demir Onal; Elif Ozdemir; Rifki Ucler; Gulten Kiyak; Pamir Eren Ersoy; Samet Yalcin; Gulten Guler; Reyhan Ersoy; Bekir Cakir

doi:10.1530/endoabs.32.P1116

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Endocrine Abstracts (2013) 32 P1116 | DOI: 10.1530/endoabs.32.P1116

ECE2013 Poster Presentations Thyroid cancer (64 abstracts)

Treatment, follow up and prognostic factors of papillary microcarcinoma

Alper Celil Usluogullari ¹ , Eda Demir Onal ¹ , Elif Ozdemir ² , Rifki Ucler ¹ , Gülten Kiyak ³ , Pamir Eren Ersoy ³ , Samet Yalcin ³ , Gülten Güler ⁴ , Reyhan Ersoy ¹ & Bekir Cakir ¹

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¹Yildirim Beyazit University Ankara Atatürk Education and Research Hospital Endocrinology and Metabolisma Diseases Department, Ankara, Turkey; ²Yildirim Beyazit University Ankara Atatürk Education and Research Hospital Nuclear Medicine Department, Ankara, Turkey; ³Yildirim Beyazit University Ankara Atatürk Education and Research Hospital General Surgery Department, Ankara, Turkey; ⁴Yildirim Beyazit University Ankara Atatürk Education and Research Hospital Pathology Department, Ankara, Turkey.

Introduction: The incidence rate of papillary thyroid microcarsinoma (PTMC) has almost doubled during the recent years but treatment and follow up is still a matter of debate. In this study we aimed to analyze clinical and histopathological risk factors at the time of diagnosis and to observe their implications for treatment, follow up and prognosis.

Patients and methods: Two hundred forty-eight PTMC patients were included in this study. The age, sex, the method of diagnosis (incidental or with a clinical suspicion), cervical lymph node metastases and relapse and/or distant metastases during follow up were retrospectively recorded.

Results: Two hundred one were female and 47 were male. Total thyroidectomy was performed in all patients. All of the patients had postsurgical radio-iodine ablation treatment. When compared according to tumor size (≤5 mm vs. >5 mm), bilateral involvement, vascular invasion, capsular invasion, extrathyroidal extension and lymph node metastases were significantly more frequent in the patients with tumor size > 5 mm (P values P<0.046, P<0.021, P<0.001, P<0.003, P<0.000 respectively). Diagnosis after a clinical suspicion and thyroglobulin (TG) value were found to be associated with lymph node metastases at the end of the multiple logistic regression analysis. The relevant TG value was 7.98 ng/ml with a sensitivity of 57.14% and specificity of 83.17%. Relapse was associated with TG value and lymph node metastases at the time of diagnosis.

Conclusion: Local relapse is significantly associated with lymph node metastases at the time of diagnosis. Regarding the treatment of PTMC our approach is to perform total/near total thyroidectomy and than RAI treatment. We think that the low relapse in this study is related with our therapeutic approach. On the other hand, PTMC should not be regarded as a relatively benign disease when our patients with lymph node metastases, local relapse and distant metastases were taken into consideration.