Clinical Significance of Tumor Size in Papillary Thyroid Microcarcinoma: a Meta-Analysis
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Purpose: To determine whether the tumor size associtates with aggressive clinicopathologic features and tumor recurrence in patients with papillary thyroid microcarcinoma (PTMC) who had undergone thyroidectomy. Clinical significance of tumor size in patients with PTMC is still controversial. Methods: A search of PubMed, MEDLINE, and EMBASE identified the clinical studies that examined the association of subgroups classified by tumor size (5 mm) in surgical specimens with aggressive clinicopathologic features, and clinical outcomes between 1976 and 2017. Seven hundred twenty relevant studies were searched, and the authors selected 34 studies, including 12,134 PTMC cases. Random effects meta-analyses were performed using odds ratios (ORs) or relative risks (RRs) with 95% confidence intervals (CIs). Results: In 34 studies, compared with the patients with small PTMC, the patients with large PTMC had a higher risk of multifocality (OR, 1.97; 95% CI, 1.61–2.40; I2, 40.7%), extrathyroidal extension (OR, 3.42; 95% CI, 2.46–4.75; I2, 64.9%), and lymph node metastasis (OR, 2.45; 95% CI, 1.79–3.37; I2, 80.5%). In 10 studies, patient with large PTMC had 1.65-fold increased risk of locoregional recurrence (95% CI, 1.20–2.27; I2, 0.0%). Conclusion: This meta-analysis showed that tumor size in PTMC is associated with high-risk clinicopathologic characteristics and tumor recurrence. These findings may be helpful to decide treatment plans for patients with PTMC larger than 5 mm.
Abstract
Purpose: To determine whether the tumor size associtates with aggressive clinicopathologic features and tumor recurrence in patients with papillary thyroid microcarcinoma (PTMC) who had undergone thyroidectomy. Clinical significance of tumor size in patients with PTMC is still controversial. Methods: A search of PubMed, MEDLINE, and EMBASE identified the clinical studies that examined the association of subgroups classified by tumor size (5 mm) in surgical specimens with aggressive clinicopathologic features, and clinical outcomes between 1976 and 2017. Seven hundred twenty relevant studies were searched, and the authors selected 34 studies, including 12,134 PTMC cases. Random effects meta-analyses were performed using odds ratios (ORs) or relative risks (RRs) with 95% confidence intervals (CIs). Results: In 34 studies, compared with the patients with small PTMC, the patients with large PTMC had a higher risk of multifocality (OR, 1.97; 95% CI, 1.61–2.40; I2, 40.7%), extrathyroidal extension (OR, 3.42; 95% CI, 2.46–4.75; I2, 64.9%), and lymph node metastasis (OR, 2.45; 95% CI, 1.79–3.37; I2, 80.5%). In 10 studies, patient with large PTMC had 1.65-fold increased risk of locoregional recurrence (95% CI, 1.20–2.27; I2, 0.0%). Conclusion: This meta-analysis showed that tumor size in PTMC is associated with high-risk clinicopathologic characteristics and tumor recurrence. These findings may be helpful to decide treatment plans for patients with PTMC larger than 5 mm.
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