J Korean Surg Soc.  2012 May;82(5):281-287.

Clinical features and prognostic factors in papillary thyroid microcarcinoma depends on age

• Cho JK
• Kim JY
• Jeong CY
• Jung EJ
• Park ST
• Jeong SH
• Ju YT
• Lee YJ
• Hong SC
• Ha WS
• Choi SK

Abstract

PURPOSE
Clinical outcomes of papillary thyroid microcarcinoma (PTMC) vary. In general, age at diagnosis is an independent prognostic factor in conventional papillary thyroid carcinoma. However, it is unclear in patients of PTMC. The purpose of this study was to identify clinicopathologic features and prognostic factors of PTMC according to patients' age.
METHODS
Five hundred twenty-seven patients who received thyroid surgery and diagnosed as having PTC between January 2001 and December 2009 were included. The clinical data were retrospectively analyzed.
RESULTS
We divided the patients into two groups; group I who were younger than 45 years, and group II who were 45 years old or older. The mean tumor size and incidences of neck lymph nodes involvement of group I was larger than group II. In group II, however, there were more patients who had multiple cancer foci and were body mass index > or = 25 kg/m2. The overall incidence of recurrent disease was 3.2%. The incidence of recurrence was higher in group II (2.0% vs. 4.0%), without a statistical difference. In multivariate analysis, the significant risk factors of recurrence were male gender and multifocality in group I, and lymph node metastasis and multifocality in group II. In particular, the male gender and multifocality showed the highest odds ratio (OR) on each group (OR, 4.721 and 6.177).
CONCLUSION
The patients with PTMCs had different clinical features and prognostic factors according to age. Hence, clinicians should consider a different strategy for therapy and plan for follow-up according to age.

Keyword

Papillary thyroid cancer; Microcarcinoma; Prognosis; Age

MeSH Terms

Body Mass Index
Carcinoma
Carcinoma, Papillary
Factor IX
Follow-Up Studies
Humans
Incidence
Lymph Nodes
Male
Multivariate Analysis
Neck
Neoplasm Metastasis
Odds Ratio
Prognosis
Recurrence
Retrospective Studies
Risk Factors
Thyroid Gland
Thyroid Neoplasms
Carcinoma
Carcinoma, Papillary
Factor IX
Thyroid Neoplasms

Figure

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  Fig. 1 Recurrence-free survival rate of papillary thyroid microcarcinoma according to age group by the Kaplan-Meier survival analysis. The recurrence-free survival was higher in group I, but there was no significant difference between the groups.

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  Fig. 2 Recurrence-free survival rate of papillary thyroid microcarcinoma (PTMC) according to sex in group I patients. (A) Stratified by sex in the group I. The recurrence-free survival of male was lower than female (log-rank = 0.010). (B) Stratified by multiplicity in the group II. The recurrence-free survival of the patients with solitary PTMCs was higher than the others (log-rank = 0.000).

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