Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Sep;5(3):180-186.
doi: 10.1159/000446746. Epub 2016 Jun 2.

Therapeutic Strategies and Clinical Outcome in Papillary Thyroid Microcarcinoma: A Multicenter Observational Study

F Cecoli  1 , E M Ceresola  1 , V Altrinetti  2 , M Cabria  2 , M Cappagli  3 , A Montepagani  3 , C M Cuttica  2 , U Filippi  4 , D Saverino  1 , M Raffa  5 , M Caputo  1 , F Minuto  1 , M Giusti  1 , M Bagnasco  1
Affiliations

Therapeutic Strategies and Clinical Outcome in Papillary Thyroid Microcarcinoma: A Multicenter Observational Study

F Cecoli et al. Eur Thyroid J. 2016 Sep.

Abstract

Purpose: Papillary thyroid microcarcinoma (MPTC) has an excellent prognosis. We aimed to evaluate the evolution of therapeutic strategies over time and the clinical outcome of MPTC.

Methods: In this retrospective multicenter observational study in a northwest Italian region, patients with intrathyroidal, unifocal tumor ≤1 cm in size, incidentally found at histology or preoperative cytology diagnosis, were included. Exclusion criteria were a previous head-and-neck irradiation and/or node metastases.

Results: From 1985 to 2012, 437 patients had an MPTC diagnosis, which was incidental in 85% and preoperative in 15%. Patients with a preoperative diagnosis were younger at the time of diagnosis (47.6 ± 12.7 years, p < 0.01) and had a larger tumor (7.0 ± 2.5 mm, p < 0.0001) than patients with an incidental diagnosis (age 52 ± 13.5 years, size 4.4 ± 2.8 mm), but there were no differences in clinical outcome between both groups. We observed a significant (p < 0.001) reduction in radioiodine remnant ablation during the years. TSH levels were: <0.1 mIU/l in 27.5%, 0.1-0.5 mlU/l in 33.7%, 0.5-2.5 mlU/l in 32.6%, 2.5-4.2 mlU/l in 3.9%, and >4.2 mlU/l in 2.3% of patients. Six patients (1.37%) had nodal recurrence; 5 of them were cured after therapy. MPTC-linked mortality was null.

Conclusions: We confirmed the favorable clinical outcome of MPTC. Despite the reduction in radioiodine ablation, overtreatment of MPTC is still observed.

Keywords: Clinical outcome; Papillary thyroid microcarcinoma; Prognosis; Therapeutic approach.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Differences in terms of age at diagnosis (a) and tumor size (b) between patients with the incidental diagnosis performed for benign thyroid disease and the preoperative diagnosis after FNAC.
Fig. 2
Fig. 2
Percentage distribution of TSH levels at the last evaluation.
Fig. 3
Fig. 3
Treatment with RAI remnant ablation among different time periods.
Fig. 4
Fig. 4
Schedule of the MPTC therapeutic approach.
Fig. 5
Fig. 5
Kaplan-Meyer curves between subgroups of patients: incidental vs. preoperative diagnosis of MPTC (b) and with RAI versus without RAI treatment (a). No significant difference was found.
See this image and copyright information in PMC

References

    1. Li N, Du XL, Reitzel LR, Xu L, Sturgis EM. Impact of enhanced detection on the increase in thyroid cancer incidence in the United States: review of incidence trends by socioeconomic status within the surveillance, epidemiology, and end results registry, 1980-2008. Thyroid. 2013;23:103–110. - PMC - PubMed
    1. Davies L, Welch HG. Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg. 2014;140:317–322. - PubMed
    1. Dal Maso L, Lise M, Zambon P, Falcini F, Crocetti E, Serraino D, Cirilli C, Zanetti R, Vercelli M, Ferretti S, Stracci F, De Lisi V, Busco S, Tagliabue G, Budroni M, Tumino R, Giacomin A, Franceschi S, AIRTUM Working Group Incidence of thyroid cancer in Italy, 1991-2005: time trends and age-period-cohort effects. Ann Oncol. 2011;22:957–963. - PubMed
    1. Livolsi VA, Saavedra JA. Papillary carcinoma. In: De Lellis RA, Lloyd RV, Heitz PU, Eng C, editors. World Health Organization. Classification of Tumours. Pathology and Genetics of Tumours of Endocrine Organs. Lyon: IARC Press; 2004. pp. 57–60.
    1. Bramley MD, Harrison BJ. Papillary microcarcinoma of the thyroid gland. Br J Surg. 1996;83:1674–1683. - PubMed