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. 2022 Nov 16:14:3181-3190.
doi: 10.2147/CMAR.S390468. eCollection 2022.

"Micro" Extrathyroidal Extension in Risk Stratification for Papillary Thyroid Carcinoma: Should It Be in the Intermediate-Risk or High-Risk Group? A Single-Center Retrospective Study

Qi He  1 , Feihong Ji  1 , Xinghao Fu  1 , Zehao Li  1 , Xinguang Qiu  1
Affiliations

"Micro" Extrathyroidal Extension in Risk Stratification for Papillary Thyroid Carcinoma: Should It Be in the Intermediate-Risk or High-Risk Group? A Single-Center Retrospective Study

Qi He et al. Cancer Manag Res. .

Abstract

Introduction: Currently, there is no consensus on the specific effect of Extrathyroidal Extension (ETE) on prognosis. The purpose of our study was to study the relationship between different states of ETE and its disease-free survival rate and to determine the basic standard of Micro ETE (tumor extends through capsule only) in risk stratification.

Material and methods: We conducted a retrospective and single-center study that included the clinical data of all papillary thyroid carcinoma (PTC) patients with ETE in our hospital from 2013 to 2017 and followed them up after rigorous screening. According to ETE state, it is divided into four groups: Microscopic, Micro, Minimal, Macro. Kaplan-Meier method was used to calculate disease-free survival (DFS). Log-rank test was used to compare the differences between the groups and to polt the survival curves. P<0.05 was considered statistically significant. Micro ETE was included in different risk stratification subgroups and their DFS was compared.

Results: A total of 436 patients were included: Microscopic group N=50 (11.47%), Micro group N=74 (16.97%), Minimal group N=135 (30.96%), and Macro group N=177 (40.60%). The frequency of ETE was in strap muscles N=191, trachea N=114, laryngeal recurrent nerve N=92, and capsule N=74, etc. The 5-year DFS rate in Micro group was 95.3%, higher than that in Macro group (P<0.05). The 5-year DFS rate of Micro ETE was 90.0% in the intermediate-risk group and 84.9% in the high-risk group when Micro ETE was included in different risk stratification subgroups.

Conclusion: Micro ETE deserves more attention, has a batter prognosis than Macro ETE, and may have little effect on recurrence. It seems more appropriate to treat Micro ETE as the intermediate-risk group in risk stratification.

Keywords: extrathyroidal extension; papillary thyroid carcinoma; prognosis; risk stratification.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow diagram for study participants.
Figure 2
Figure 2
Extrathyroidal extension state.
Figure 3
Figure 3
Frequency histogram of each site of extrathyroidal extension.
Figure 4
Figure 4
Kaplan–Meier survival plots stratified by extent of ETE for patients with PTC. (A) Disease-free survival of four groups; (B) Disease-free survival of Micro ETE was included in the intermediate-risk group; (C) Disease-free survival of Micro ETE was included in the high-risk group.
See this image and copyright information in PMC

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