Risk Factors Associated With Persistent Disease, Recurrence and Evidence of Disease 5 Years After Treatment in Papillary Thyroid Cancers Smaller Than 2 cm With and Without Gross Extrathyroidal Extension
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Papillary thyroid carcinomas (PTCs) are often characterized by recurrence, persistent disease, and evidence of disease 5 years after treatment. Such factors may be influenced by gross extrathyroidal extension (ETE), which may not be easily distinguished preoperatively using ultrasonography. This study aimed to analyze whether the risk factors associated with the adverse events mentioned above would differ between PTCs measuring ≤2 cm within the thyroid gland and PTCs measuring ≤2 cm regardless of invasion status. Methods: We retrospectively analyzed all patients with PTC ≤2 cm who underwent surgery between 2002 and 2017. Patients were categorized into 2 groups: All (PTC ≤2 cm tumors including ETE) and No ETE (tumor ≤2 cm, limited to the thyroid gland). Results: In the All group, those with T4a and N1a/N1b status demonstrated a higher risk of recurrence, whereas the No ETE group tended to have more cases of disease recurrence at a younger age, margin-positive cases, and N1a/N1b patients. Furthermore, the All group demonstrated a higher rate of persistent disease in N1a/N1b patients, and evidence of disease 5 years after treatment was present in patients with positive ETE (N1b). Conclusion: Assessing tumor invasion preoperatively may be difficult; therefore, differences in factors associated with recurrence, persistent disease, and evidence of disease 5 years after treatment should be considered preoperatively.
Abstract
Purpose: Papillary thyroid carcinomas (PTCs) are often characterized by recurrence, persistent disease, and evidence of disease 5 years after treatment. Such factors may be influenced by gross extrathyroidal extension (ETE), which may not be easily distinguished preoperatively using ultrasonography. This study aimed to analyze whether the risk factors associated with the adverse events mentioned above would differ between PTCs measuring ≤2 cm within the thyroid gland and PTCs measuring ≤2 cm regardless of invasion status. Methods: We retrospectively analyzed all patients with PTC ≤2 cm who underwent surgery between 2002 and 2017. Patients were categorized into 2 groups: All (PTC ≤2 cm tumors including ETE) and No ETE (tumor ≤2 cm, limited to the thyroid gland). Results: In the All group, those with T4a and N1a/N1b status demonstrated a higher risk of recurrence, whereas the No ETE group tended to have more cases of disease recurrence at a younger age, margin-positive cases, and N1a/N1b patients. Furthermore, the All group demonstrated a higher rate of persistent disease in N1a/N1b patients, and evidence of disease 5 years after treatment was present in patients with positive ETE (N1b). Conclusion: Assessing tumor invasion preoperatively may be difficult; therefore, differences in factors associated with recurrence, persistent disease, and evidence of disease 5 years after treatment should be considered preoperatively.
참고문헌 (15)
- Kilfoy BA, "International patterns and trends in thyroid cancer incidence, 1973-2002", Cancer Causes Control, 20, pp.525~531 (2009)
- Leenhardt L, "Advances in diagnostic practices affect thyroid cancer incidence in France", Eur J Endocrinol, 150, pp.133~139 (2004)
- Ahn HS, "Korea’s thyroid-cancer"epidemic"--screening and overdiagnosis", N Engl J Med, 371, pp.1765~1767 (2014)
- Mazzaferri EL, "Long-term outcome of patients with differentiated thyroid carcinoma : effect of therapy", Endocr Pract, 6, pp.469~476 (2000)
- Bilimoria KY, "Utilization of total thyroidectomy for papillary thyroid cancer in the United States", Surgery, 142, pp.906~913 (2007)
- Jung YS, "Long-term survival of patients with thyroid cancer according to the methods of tumor detection : a nationwide cohort study in Korea", PLoS One, 13, pp.e0194743~ (2018)
- Pellegriti G, "Clinical behavior and outcome of papillary thyroid cancers smaller than 1. 5 cm in diameter : study of 299 cases", J Clin Endocrinol Metab, 89, pp.3713~3720 (2004)
- Amin M, "AJCC cancer staging manual" (2017), Springer
- Arora N, "Extrathyroidal extension is not all equal : implications of macroscopic versus microscopic extent in papillary thyroid carcinoma", Surgery, 144, pp.942~947 (2008)
- Castagna MG, "Small papillary thyroid carcinoma with minimal extrathyroidal extension should be managed as ATA low-risk tumor", J Endocrinol Invest, 41, pp.1029~1035 (2018)
- Nam SH, "A comparison of the 7th and 8th editions of the AJCC staging system in terms of predicting recurrence and survival in patients with papillary thyroid carcinoma", Oral Oncol, 87, pp.158~164 (2018)
- Rossi R, "Differentiated thyroid cancers 11-20mm in diameter have clinical and histopathologic characteristics suggesting higher aggressiveness than those < or =10 mm", Thyroid, 18, pp.309~315 (2008)
- Perrino M, "Outcome predictors and impact of central node dissection and radiometabolic treatments in papillary thyroid cancers < or =2 cm", Endocr Relat Cancer, 16, pp.201~210 (2009)
- Kluijfhout WP, "Microscopic positive tumor margin does not increase the risk of recurrence in patients with T1-T2 well-differentiated thyroid cancer", Ann Surg Oncol, 23, pp.1446~1451 (2016)
- Ahn HS, "South Korea’s thyroid-cancer"epidemic"--turning the tide", N Engl J Med, 373, pp.2389~2390 (2015)