Prediction of Contralateral Occult Malignant Nodule in Patients with Unilaterally Confined Papillary Thyroid Carcinomas
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Purpose: The purpose of this study was to assess the presence of contralateral occult malignant foci (OMF) among patients who confined unilateral papillary thyroid carcinomas (PTCs). Methods: From January 2010 to December 2012, we retrospectively evaluated 714 patients who received total thyroidectomy with central lymph node (LN) dissection after being diagnosed as having unilaterally confined PTC. By dividing the patients into 2 groups according to the presence or absence of contralateral OMF, the relationship between OMF and clinicopathological factors such as age, sex, tumor size, multifocality, chronic lymphocytic/Hashimoto's thyroiditis, contralateral lobe benign nodule, extrathyroidal extension (ETE), and central LN metastasis. Results: When the patients were subdivided based on primary tumor size, OMF in the contralateral lobe were more frequently found as the tumor sizes increased, with statistical significance (P=0.012). In the patients with multifocal thyroid cancer in the lobe that had primary tumor, OMF was observed in the other lobe regardless of the number of primary malignant nodules, and the difference was statistically significant (P=0.001). Conclusion: The primary tumor size or multifocality is a risk factor that can predict the presence of contralateral lobe occult cancers. We suggest that patient needs to carefully observe the remaining contralateral lobe, taking into consideration the size and multifocality of the primary tumor, when performing unilateral thyroid lobectomy.
Abstract
Purpose: The purpose of this study was to assess the presence of contralateral occult malignant foci (OMF) among patients who confined unilateral papillary thyroid carcinomas (PTCs). Methods: From January 2010 to December 2012, we retrospectively evaluated 714 patients who received total thyroidectomy with central lymph node (LN) dissection after being diagnosed as having unilaterally confined PTC. By dividing the patients into 2 groups according to the presence or absence of contralateral OMF, the relationship between OMF and clinicopathological factors such as age, sex, tumor size, multifocality, chronic lymphocytic/Hashimoto's thyroiditis, contralateral lobe benign nodule, extrathyroidal extension (ETE), and central LN metastasis. Results: When the patients were subdivided based on primary tumor size, OMF in the contralateral lobe were more frequently found as the tumor sizes increased, with statistical significance (P=0.012). In the patients with multifocal thyroid cancer in the lobe that had primary tumor, OMF was observed in the other lobe regardless of the number of primary malignant nodules, and the difference was statistically significant (P=0.001). Conclusion: The primary tumor size or multifocality is a risk factor that can predict the presence of contralateral lobe occult cancers. We suggest that patient needs to carefully observe the remaining contralateral lobe, taking into consideration the size and multifocality of the primary tumor, when performing unilateral thyroid lobectomy.
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