Korean J Endocr Surg.  2009 Jun;9(2):79-84. 10.16956/kjes.2009.9.2.79.

Clinical Characteristics and Prognostic Factors of Papillary Microcarcinoma: Results from Retrospective Analysis of 176 Patients

• Song DK
• Choi YJ
• Kang YJ
• Park HW
• Park JS
• Joe BS
• Kim CN
• Lee MK

• KMID: 2375750
• DOI: http://doi.org/10.16956/kjes.2009.9.2.79

Abstract

PURPOSE
The clinical importance and characteristics of papillary thyroid microcarcinoma (PTC) are still under debate, and the criteria for appropriate treatment have yet to be established. In this study, we attempted to examine the appropriate extent of surgery and the desirability of prophylactic lymph node (LN) dissection through identification of factors influencing LN metastasis and capsular invasions.
METHODS
We reviewed the medical records of 176 consecutive biopsy-proven PTC patients. The clinical and pathological prognostic factors including LN metastasis and capsular invasion were analyzed. Chi-square test and independent sample T-test were used for statistical analysis.
RESULTS
The median age of patients was 47-years-of-age (range 23~80 years). Among 108 patients who underwent central LN dissection, 38 (35.8%) patients showed LN metastasis. Univariate analysis revealed that male patients showed significantly more LN metastasis than female patients and lymphovascular invasion significantly affected LN metastasis. Twenty-eight (14.8%) patients showed capsular invasion. Tumor size, especially tumors ≥5 mm in diameter, and tumor multiplicity were significantly associated with capsular Invasion. Lymphatic or venous invasion also affected the occurrence of capsular invasion.
CONCLUSION
Patients who are male, have a tumor larger than 5 mm in diameter, or multiple tumors are more likely to develop LN metastasis or capsular invasions. These factors could help us to decide the extent of thyroidectomy and to select patients who need prophylactic LN dissection.

Keyword

Papillary thyroid microcarcinoma; Lymph node metastasis; Capsular invasion

MeSH Terms

Female
Humans
Lymph Nodes
Male
Medical Records
Neoplasm Metastasis
Retrospective Studies*
Thyroid Gland
Thyroidectomy