Papillary thyroid microcarcinoma: characteristics at presentation, and evaluation of clinical and histological features associated with a worse prognosis in a Latin American cohort
ABSTRACT Objective We aimed to describe the presentation of papillary microcarcinoma (PTMC) and identify the clinical and histological features associated with persistence/recurrence in a Latin American cohort. Subjects and methods Retrospective study of PTMC patients who underwent total thyroidec...
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doaj-8d1606bfd90f4267b291d97ff927be392020-11-25T02:39:50ZengBrazilian Society of Endocrinology and MetabolismArchives of Endocrinology and Metabolism2359-429262161310.20945/2359-3997000000013S2359-39972018000100006Papillary thyroid microcarcinoma: characteristics at presentation, and evaluation of clinical and histological features associated with a worse prognosis in a Latin American cohortJosé M. DomínguezFlavia NiloMaría T. MartínezJosé M. MassardoSueli MuñozTania ContrerasRocío CarmonaJoaquín JerezHernán GonzálezNicolás DroppelmannAugusto LeónABSTRACT Objective We aimed to describe the presentation of papillary microcarcinoma (PTMC) and identify the clinical and histological features associated with persistence/recurrence in a Latin American cohort. Subjects and methods Retrospective study of PTMC patients who underwent total thyroidectomy, with or without radioactive iodine (RAI), and who were followed for at least 2 years. Risk of recurrence was estimated with ATA 2009 and 2015 classifications, and risk of mortality with 7th and 8th AJCC/TNM systems. Clinical data obtained during follow-up were used to detect structural and biochemical persistence/recurrence. Results We included 209 patients, predominantly female (90%), 44.5 ± 12.6 years old, 183 (88%) received RAI (90.4 ± 44.2 mCi), followed-up for a median of 4.4 years (range 2.0–7.8). The 7th and 8th AJCC/TNM system classified 89% and 95.2% of the patients as stage I, respectively. ATA 2009 and ATA 2015 classified 70.8% and 78.5% of the patients as low risk, respectively. Fifteen (7%) patients had persistence/recurrence during follow-up. In multivariate analysis, only lymph node metastasis was associated with persistence/recurrence (coefficient beta 4.0, p = 0.016; 95% CI 1.3-12.9). There were no PTMC related deaths. Conclusions Our series found no mortality and low rate of persistence/recurrence associated with PTMC. Lymph node metastasis was the only feature associated with recurrence in multivariate analysis. The updated ATA 2015 and 8th AJCC/TNM systems classified more PTMCs than previous classifications as low risk of recurrence and mortality, respectively.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972018000100006&lng=en&tlng=enThyroid cancerhead and neckendocrine |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
José M. Domínguez Flavia Nilo María T. Martínez José M. Massardo Sueli Muñoz Tania Contreras Rocío Carmona Joaquín Jerez Hernán González Nicolás Droppelmann Augusto León |
spellingShingle |
José M. Domínguez Flavia Nilo María T. Martínez José M. Massardo Sueli Muñoz Tania Contreras Rocío Carmona Joaquín Jerez Hernán González Nicolás Droppelmann Augusto León Papillary thyroid microcarcinoma: characteristics at presentation, and evaluation of clinical and histological features associated with a worse prognosis in a Latin American cohort Archives of Endocrinology and Metabolism Thyroid cancer head and neck endocrine |
author_facet |
José M. Domínguez Flavia Nilo María T. Martínez José M. Massardo Sueli Muñoz Tania Contreras Rocío Carmona Joaquín Jerez Hernán González Nicolás Droppelmann Augusto León |
author_sort |
José M. Domínguez |
title |
Papillary thyroid microcarcinoma: characteristics at presentation, and evaluation of clinical and histological features associated with a worse prognosis in a Latin American cohort |
title_short |
Papillary thyroid microcarcinoma: characteristics at presentation, and evaluation of clinical and histological features associated with a worse prognosis in a Latin American cohort |
title_full |
Papillary thyroid microcarcinoma: characteristics at presentation, and evaluation of clinical and histological features associated with a worse prognosis in a Latin American cohort |
title_fullStr |
Papillary thyroid microcarcinoma: characteristics at presentation, and evaluation of clinical and histological features associated with a worse prognosis in a Latin American cohort |
title_full_unstemmed |
Papillary thyroid microcarcinoma: characteristics at presentation, and evaluation of clinical and histological features associated with a worse prognosis in a Latin American cohort |
title_sort |
papillary thyroid microcarcinoma: characteristics at presentation, and evaluation of clinical and histological features associated with a worse prognosis in a latin american cohort |
publisher |
Brazilian Society of Endocrinology and Metabolism |
series |
Archives of Endocrinology and Metabolism |
issn |
2359-4292 |
description |
ABSTRACT Objective We aimed to describe the presentation of papillary microcarcinoma (PTMC) and identify the clinical and histological features associated with persistence/recurrence in a Latin American cohort. Subjects and methods Retrospective study of PTMC patients who underwent total thyroidectomy, with or without radioactive iodine (RAI), and who were followed for at least 2 years. Risk of recurrence was estimated with ATA 2009 and 2015 classifications, and risk of mortality with 7th and 8th AJCC/TNM systems. Clinical data obtained during follow-up were used to detect structural and biochemical persistence/recurrence. Results We included 209 patients, predominantly female (90%), 44.5 ± 12.6 years old, 183 (88%) received RAI (90.4 ± 44.2 mCi), followed-up for a median of 4.4 years (range 2.0–7.8). The 7th and 8th AJCC/TNM system classified 89% and 95.2% of the patients as stage I, respectively. ATA 2009 and ATA 2015 classified 70.8% and 78.5% of the patients as low risk, respectively. Fifteen (7%) patients had persistence/recurrence during follow-up. In multivariate analysis, only lymph node metastasis was associated with persistence/recurrence (coefficient beta 4.0, p = 0.016; 95% CI 1.3-12.9). There were no PTMC related deaths. Conclusions Our series found no mortality and low rate of persistence/recurrence associated with PTMC. Lymph node metastasis was the only feature associated with recurrence in multivariate analysis. The updated ATA 2015 and 8th AJCC/TNM systems classified more PTMCs than previous classifications as low risk of recurrence and mortality, respectively. |
topic |
Thyroid cancer head and neck endocrine |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972018000100006&lng=en&tlng=en |
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