Papillary thyroid microcarcinoma: clinical and pathological study of 321 cases.

Džepina, Davor and Bedeković, Vladimir and Čupić, Hrvoje and Krušlin, Božo (2012) Papillary thyroid microcarcinoma: clinical and pathological study of 321 cases. Collegium Antropologicum, 36 (S2). pp. 39-45. ISSN 0350-6134

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Abstract

The primary aim of the study was to investigate microcarcinoma characteristics of aggressivity, multicentricity and metastasis. Though its features are not significantly different from those of other papillary carcinomas, the optimal therapeutic approach continues to be an issue of controversy, most notably appropriate surgical approach and indications for neck dissection. The study is retrospective analysis of 321 microcarcinoma cases, operated upon with total thyroidectomy, with or without neck dissection. These cases were compared to larger papillary cancers. We found that 35.1% tumors were aggressive; 25.2% were multicentric, with foci in the contralateral lobe nearly twice as often as in the ipsilateral lobe; and 18.2% were metastatic. In comparison to groups of < or = 2 cm and < or = 3 cm, microcarcinomas were less aggressive, multicentric and metastatic. Male gender and age < 45 were unfavorable parameters. Multivariate analysis revealed contralateral lobe multicentricity and male gender as risk factors for metastasis. Although microcarcinoma demonstrated better characteristics than larger tumors, this subgroup behaves aggressively and should be approached cautiously.

Abstract in Croatian

PAPILARNI MIKROKARCINOM ŠTITNJAČE: KLINIČKA I PATOLOŠKA STUDIJA 321 SLUČAJA ----- Osnovni cilj studije bio je istražiti patološku agresivnost, multicentričnost i metastatske osobitosti papilarnog mikrokarcinoma štitnjače. Postavljene su hipoteze da je mikrokarcinom sklon pojavi multicentričnih žarišta tumora i lokoregionalnom širenju; multicentričnost nije povezana sa veličinom niti agresivnošću tumora; agresivnost i metastatsko širenje povezano je sa dobi i spolom. Metode: retrospektivna analiza 321 slučaja mikrokarcinoma, operiranih totalnom tireoidektomijom sa ili bez disekcije vrata. Svi slučajevi uspoređeni su sa papilarnim karcinomima veće veličine primarnog tumora. Rezultati: 35,1% tumora je bilo agresivno; 25,2% je pokazalo multicentričnost, sa žarištima u kontralateralnom režnju približno dvostruko češće nego u ipsilateralnom režnju; 18,2% tumora je metastaziralo lokoregionalno. U usporedbi sa odvojenom grupom tumora od ≤2 cm and ≤3 cm, mikrokarcinomi su bili manje agresivni, multicentrični i metastatski. Muški spol i dob <45 godina pokazani su kao nepovoljni klinički parametri. Multivarijantna analiza pokazala je postojanje multicentričnih žarišta u kontralateralnom režnju te muški spol kao rizične čimbenike za pojavu metastaza. Zaključak: premda je mikrokarcinom u ovoj studiji pokazao bolje kliničko ponašanje od papilarnih karcinoma veličine veće od 1 cm, ova podgrupa tumora ponašala se značajno agresivno te savjetujemo nužni oprez u kliničkom pristupu ovoj značajnoj podgrupi pacijenata.

Item Type: Article
Departments: Katedra za patologiju
Depositing User: Marijan Šember
Status: Published
Creators:
CreatorsEmail
Džepina, DavorUNSPECIFIED
Bedeković, VladimirUNSPECIFIED
Čupić, HrvojeUNSPECIFIED
Krušlin, BožoUNSPECIFIED
Date: November 2012
Date Deposited: 06 Mar 2013 11:14
Last Modified: 06 Mar 2013 11:14
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/1864

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