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Prognostic significance of tumor multifocality in papillary thyroid carcinoma and its relationship with primary tumor size: a retrospective study of 2,309 consecutive patients

Authors
 Kuk-Jin Kim  ;  Seok-Mo Kim  ;  Yong Sang Lee  ;  Woong Youn Chung  ;  Hang-Seok Chang  ;  Cheong Soo Park 
Citation
 ANNALS OF SURGICAL ONCOLOGY, Vol.22(1) : 125-131, 2015 
Journal Title
 ANNALS OF SURGICAL ONCOLOGY 
ISSN
 1068-9265 
Issue Date
2015
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Papillary/pathology* ; Carcinoma, Papillary/radiotherapy ; Carcinoma, Papillary/surgery ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Iodine Radioisotopes/therapeutic use* ; Lymph Node Excision ; Male ; Middle Aged ; Neoplasm Recurrence, Local/pathology* ; Neoplasm Recurrence, Local/radiotherapy ; Neoplasm Recurrence, Local/surgery ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Risk Factors ; Thyroid Neoplasms/pathology* ; Thyroid Neoplasms/radiotherapy ; Thyroid Neoplasms/surgery ; Young Adult
Keywords
Papillary Thyroid Carcinoma ; Total Thyroidectomy ; Primary Tumor Size ; Tumor Multifocality ; Completion Thyroidectomy
Abstract
BACKGROUND: Tumor multifocality is frequently observed in papillary thyroid carcinoma (PTC), but its prognostic value is controversial. We investigated the prognostic significance of multifocality in PTCs larger than 1 cm and papillary thyroid microcarcinomas (PTMC). METHODS: Medical records and pathologic results of 2,309 patients who received thyroidectomy and lymph node dissection for PTC were retrospectively reviewed. We identified 648 patients who had PTC with a primary tumor exceeding 1 cm, and 1,661 patients with PTMC. In each group, we compared patients with unifocal and multifocal disease. Cox regression analyses of disease persistence and recurrence were performed to identify the prognostic significance of multifocality. RESULTS: The mean follow-up period was 5.6 years. In the analyses of PTCs larger than 1 cm, the multifocal group included more extensive thyroid surgeries (p = 0.039), radioactive iodine therapies with higher doses (p < 0.001), and significantly higher rates of disease persistence and recurrence (p = 0.001) compared with the unifocal group. In analogous analyses of patients with PTMC, disease persistence and recurrence did not differ significantly between the unifocal and multifocal groups. Cox regression analyses indicated that multifocality was an independent risk factor for disease persistence and recurrence in patients who had PTC with a tumor exceeding 1 cm, but not in patients with PTMC. CONCLUSION: Tumor multifocality appears to be an important prognostic factor for PTCs larger than 1 cm, but may have little or no prognostic significance for PTMC.
Full Text
http://link.springer.com/article/10.1245%2Fs10434-014-3899-8
DOI
10.1245/s10434-014-3899-8
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seok Mo(김석모) ORCID logo https://orcid.org/0000-0001-8070-0573
Park, Cheong Soo(박정수)
Lee, Yong Sang(이용상) ORCID logo https://orcid.org/0000-0002-8234-8718
Chang, Hang Seok(장항석) ORCID logo https://orcid.org/0000-0002-5162-103X
Chung, Woong Youn(정웅윤)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139813
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