ECE2016 Oral Communications Thyroid Cancer (5 abstracts)
Prognostic value of microscopic extrathyroid extension in papillary thyroid carcinoma
Bernardo Marques , Raquel Martins , Joana Couto , Jacinta Santos , Teresa Martins , Pedro Mesquita , Patrícia Gilde , Ivan Portela , Eugénia Rovira , Sofia Oliveira , Carlos Cruz , João Neto & Fernando Rodrigues
Portuguese Institute of Oncology of Coimbra FG, EPE, Coimbra, Portugal.
Introduction: Although recognized as a risk factor in most staging systems, including the UICC TNM classification, the significance of microscopic extrathyroid extension (ETE) in papillary thyroid carcinoma (PTC) remains controversial. Despite this fact, its diagnosis by a pathologist following surgery for tumours ≤ 4 cm without metastases means an upstaging to pT3 and stage III in patients over 45 years, implying a poorer survival. Our study aimed to evaluate the impact of microscopic ETE on outcome in patients with otherwise T1 and T2 PTC.
Methods/design: This was a retrospective study of 603 consecutive patients identified from our institutional database, who underwent surgery for PTC between 2000 and 2012. All patients had: tumours ≤ 4 cm, apparent complete tumor resection, without clinically apparent lymph node or distant metastasis at diagnosis and nonaggressive histologic variant. The association between variables was assessed using chi-square and Student’s t-tests.
Results: All patients were followed for a minimum of 3 years postoperatively (76.7±48.7 months). Ninety four (15.6%) patients were upstaged to T3 based on the finding of microscopic ETE.
These patients were older (54.3±12.4 versus 49.9±14.2 years; P=0.005) and had larger tumours (15.9±9.3 versus 13.5±9.7 mm; P=0.0025). Radioiodine ablation therapy was administered more often to T3 patients (97.7% versus 40.2%; P<0.001), as well as prophylactic lymph node resection (37.6% versus 25.6%; P=0.017). There were no significant associations between microscopic ETE and extension of thyroid surgery (total thyroidectomy was performed in 94.9% of T1/T2 patients versus 97.9% of T3 patients; P=0.288), in recurrence rate (3.8% versus 6.7%; P=0.245) or persistence of disease at the end of the follow-up period (1.7% versus 4.4%; P=0.106). No disease-specific mortality occurred in either group.
Conclusion: Our results suggest that upstaging of T1/T2 PTC because of microscopic ETE may not have an impact on patients’ outcomes, namely recurrence, persistence of disease and mortality.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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