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Ann Surg Oncol. 2009 Sep;16(9):2609-16. doi: 10.1245/s10434-009-0565-7. Epub 2009 Jun 16.

High recurrent rate of multicentric papillary thyroid carcinoma.

Author information

1
Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Kweishan County, Taoyuan Hsien, Taiwan ROC. einjd@adm.cgmh.org.tw

Abstract

BACKGROUND:

Multicentric papillary thyroid carcinoma (PTC) is not unusual in patients with PTC. However, its clinical features concerning cancer recurrence and mortality are not well described.

METHODS:

A total of 1682 PTC patients at a single institution who underwent total thyroidectomy were retrospectively reviewed; the mean follow-up period was 7.7 +/- 0.1 years. Postoperative radioactive iodide ablation for thyroid remnant was performed after surgery for most patients.

RESULTS:

Of all the PTC cases reviewed, 337 cases (20.0%) were categorized as multicentric PTC. Compared with patients with unifocal PTC, multicentric PTC patients demonstrated older age, advanced TNM staging, and higher recurrence. A higher recurrence rate for multicentric PTC (20.2%) was observed compared with that for unifocal PTC; 45.8% of multicentric PTC cases with >or= 5 foci experienced cancer recurrence. Mean tumor size of the largest nodule in patients with multicentric PTC was significantly smaller than that found in unifocal PTC. Patients with multicentric papillary microcarcinoma (<or=1 cm) had higher recurrence rate and cancer mortality than those with unifocal papillary microcarcinoma. Of the recurrent multicentric PTC cases, 52.9% were persistent or diagnosed within the first year of thyroidectomy and had a cancer-related mortality of 27.8%. The 5-, 10-, and 20-year survival rates of multicentric PTC patients were 97.7%, 94.4%, and 84.7%, respectively, which were not statistically different from those of unifocal PTC patients.

CONCLUSIONS:

Multicentric PTC warrant postoperative adjuvant therapy and close surveillance within the first year. Patients with multicentric papillary thyroid microcarcinoma need to be treated as high-risk patients.

PMID:
19533244
DOI:
10.1245/s10434-009-0565-7
[Indexed for MEDLINE]

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