Can ultrasonography be a surrogate marker for predicting clinical outcome of a patient with conventional papillary thyroid cancer?

Abstract

Background: Ultrasonography (US) features such as ill-defined margin and microcalcification were reported to be associated with recurrence. We investigated whether if US features as well as clinicopathologic factors can be a surrogate marker in predicting clinical outcome of a patient with conventional papillary thyroid carcinoma (PTC) in a relatively large sample data.Methods: This retrospective study included 553 patients diagnosed with conventional PTC. Patient’s clinical records, US and clinicopathologic features were reviewed. Patients were followed to observe recurrence (mean period of 67.6 months). Multivariable Cox proportional hazards regression model was used to identify the effect of the variable factors on tumor recurrence. Results: Of 553 patients, 45 (8.1%) were confirmed to have tumor recurrence within the follow-up periods. Independent predictors of recurrence were male gender, tumor size, the presence of lateral LN metastasis, and not well-circumscribed margins, and taller than wide shape on US. Among the independent predictors, presence of lateral LN metastasis was the highest risk factor calculated for recurrence (HR=4.038) followed by taller than wide shape (HR=2.382) and not well-circumscribed margin (HR=2.314) on US.Conclusions: Not well-circumscribed margin and taller than wide shape on US can be used as a surrogate marker for predicting clinical outcome of a patient with conventional PTC along with clinicopathologic factors such as the presence of lateral LN metastasis, male gender, and tumor size.