Korean J Otorhinolaryngol-Head Neck Surg.  2009 Jun;52(6):512-515. 10.3342/kjorl-hns.2009.52.6.512.

Clinical Characteristics of Multifocal Papillary Thyroid Carcinoma

• Lee JK
• Lee DG
• Lee JC
• Lee BJ
• Wang SG
• Son SM
• Kim IJ
• Kim YK

• KMID: 2277067
• DOI: http://doi.org/10.3342/kjorl-hns.2009.52.6.512

Abstract

BACKGROUND AND OBJECTIVES: Papillary thyroid cancers (PTCs) often present as multifocal tumors. Whether multifocal tumors are associated with increased risk of recurrence and mortality is still the subject of controversy. The aim of current study was to individualize factors associated with multifocality of papillary thyroid cancer and determine the clinical significance of multifocal thyroid cancer.
SUBJECTS AND METHOD
We undertook a retrospective study of 403 patients treated between January, 2003 and June, 2007 for papillary thyroid carcinoma by total thyroidectomy and central compartment neck dissection (n=403) with or without comprehensive lateral neck dissection. There were 342 women and 61 men whose mean age was 47.3 years old. Following criteria were used to study the pattern of and factors related with multifocality : sex, age, extracapsular extension, central compartment lymph node metastasis, the involvement of lateral neck lymph node, AMES risk group, distant metastasis.
RESULTS
Of those factors, sex (p=0.0481), central compartment lymph node metastasis (p=0.0007), the involvement of lateral neck lymph node (p=0.0001) were significantly related factors for multifocality of papillary thyroid cancer. Age, primary tumor size, AMES risk group were not significantly related with multifocality. Bilateral or contralateral central compartment lymph node metastasis occurred more frequently in multifocal PTCs (64.0%) than solitary PTCs (46.9)(p=0.012).
CONCLUSION
Our data suggest that the multifocal tumors in patients with papillary thyroid carcinoma are associated with increased risk of bilateral central compartment and lateral cervical lymph node metastasis. Therefore, total thyroidectomy and bilateral central compartment lymph node dissection should be recommended as a routine procedure in multifocal papillary carcinoma

Keyword

Papillary thyroid cancer; Multifocal; Metastasis; Lymphatic

MeSH Terms

Carcinoma
Carcinoma, Papillary
Factor IX
Female
Humans
Lymph Node Excision
Lymph Nodes
Male
Neck
Neck Dissection
Neoplasm Metastasis
Recurrence
Retrospective Studies
Sex Factors
Thyroid Gland
Thyroid Neoplasms
Thyroidectomy
Carcinoma
Factor IX
Thyroid Neoplasms