Yonsei Med J.  2015 Mar;56(2):355-361. 10.3349/ymj.2015.56.2.355.

Total Surface Area Is Useful for Differentiating between Aggressive and Favorable Multifocal Papillary Thyroid Carcinomas

Affiliations
  • 1Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. jhpath.sohn@samsung.com
  • 2Department of Pathology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
  • 3Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

PURPOSE
The purpose of the present study was to identify more useful parameters for predicting behaviors of multifocal papillary thyroid carcinoma (PTC).
MATERIALS AND METHODS
We investigated dominant tumor diameter (TD), total tumor diameter (TTD), and total surface area (TSA) in tumors from 588 patients and evaluated their usefulness as parameters for assessment of tumor behaviors in multifocal PTCs.
RESULTS
In 588 PTCs, tumor multifocality was found in 179 PTCs (30.4%). Multifocal tumors were significantly associated with extrathyroidal extension, lymph node metastasis, and higher tumor stage grouping (p<0.001, p<0.001, and p<0.001, respectively). The rates of nodal metastasis increased with greater TSA and TTD in PTCs. Multifocal papillary thyroid microcarcinomas (mPMCs) with TSA >3.14 cm2 had higher rates of nodal metastasis than mPMCs with TSA < or =3.14 cm2 (p=0.038); however, there was no significant difference between mPMCs with TTD >1.0 cm and with TTD < or =1.0 cm (p=0.325). In addition, nodal metastasis was more frequent in mPMCs with TSA >3.14 cm2 than in unifocal papillary thyroid microcarcinomas (uPMCs) (TD < or =1.0 cm) (p=0.002), but not overt unifocal PTCs (TD >1.0 cm) (p=0.244).
CONCLUSION
Our results suggest that mPMCs with TSA >3.14 cm2 show more aggressive behavior than uPMCs and mPMCs with TSA < or =3.14 cm2. TSA could be useful in distinguishing aggressive mPMCs from favorable cases.

Keyword

Papillary thyroid carcinoma; multifocal; total surface area; lymph node metastasis

MeSH Terms

Adult
Aged
Carcinoma/*pathology/surgery
Carcinoma, Papillary/*pathology/surgery
Female
Humans
Lymph Nodes/*pathology/surgery
Lymphatic Metastasis/*pathology
Male
Middle Aged
Neoplasm Staging
Predictive Value of Tests
Prognosis
Thyroid Neoplasms/*pathology/surgery
Thyroidectomy

Figure

  • Fig. 1 Examples of measurements of tumor diameter. (A and B) Well-demarcated papillary thyroid carcinoma. (C and D) Papillary thyroid carcinoma with infiltrative border (×20).


Cited by  1 articles

Detection of Tumor Multifocality Is Important for Prediction of Tumor Recurrence in Papillary Thyroid Microcarcinoma: A Retrospective Study and Meta-Analysis
Jung-Soo Pyo, Jin Hee Sohn, Guhyun Kang
J Pathol Transl Med. 2016;50(4):278-286.    doi: 10.4132/jptm.2016.03.29.


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