Endocrinol Metab.  2012 Sep;27(3):194-199. 10.3803/EnM.2012.27.3.194.

Predictive Factors for Incidental Contralateral Carcinoma in Patients with Unilateral Micropapillary Thyroid Carcinoma

• Huh JE
• Kim SS
• Kang JH
• Choi BG
• Lee BJ
• Lee JC
• Jeon YK
• Kim BH
• Wang SG
• Kim YK
• Kim IJ

• KMID: 2282402
• DOI: http://doi.org/10.3803/EnM.2012.27.3.194

Abstract

BACKGROUND
Whether thyroid lobectomy alone is a sufficient treatment for papillary thyroid microcarcinoma (PTMC) remains controversial. The aim of this study is to evaluate the predictive factors for incidental contralateral carcinoma in patients confirmed of unilateral PTMC preoperatively.
METHODS
Between January 2007 and December 2009, 393 patients underwent thyroid surgery for unifocal and unilateral PTMC preoperatively at Pusan National University Hospital. A total thyroidectomy with central neck dissection was routinely performed for these patients during this study period.
RESULTS
Among the 393 cases in the cohort, 77 patients (19.6%) had incidental PTMC in the contralateral lobe. In patients with incidental contralateral carcinoma, there was higher prevalence in extrathyroid extension, occult ipsilateral carcinoma, pathologic Hashimoto's thyroiditis, and central lymph node metastasis compared to those without contralateral carcinoma. The mean tumor size also increased in patients with contralateral carcinoma. Multivariate logistic regression showed that extrathyroid extension (P = 0.049), occult ipsilateral carcinoma (P < 0.001), pathologic Hashimoto's thyroiditis (P = 0.038), and central lymph node metastasis (P = 0.002) were predictive factors for incidental contralateral carcinoma.
CONCLUSION
In conclusion, multifocality in the ipsilateral lobe, central lymph node metastasis, extrathyroid extension, and Hashimoto's thyroiditis is associated with the presence of contralateral carcinoma. Thus, if these factors are found by preoperative and/or postoperative evaluation, total thyroidectomy or completion thyroidectomy is necessary for the treatment of PTMC.

Keyword

Bilateral; Hashimoto disease; Incidental finding; Papillary thyroid carcinoma; Thyroidectomy

MeSH Terms

Carcinoma
Carcinoma, Papillary
Cohort Studies
Hashimoto Disease
Humans
Incidental Findings
Logistic Models
Lymph Nodes
Neck Dissection
Neoplasm Metastasis
Prevalence
Thyroid Gland
Thyroid Neoplasms
Thyroidectomy
Thyroiditis
Carcinoma
Carcinoma, Papillary
Thyroid Neoplasms

Figure

• 

  Fig. 1 Receiver-operating characteristics curves for point score associated with incidental contralateral carcinoma.

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