The Midwest Surgical AssociationContralateral papillary thyroid cancer: does size matter?
Section snippets
Methods
We reviewed the prospective University of Wisconsin Endocrine Surgery database to identify all patients with PTC who underwent either TT or CT from May 1994 to January 2007. Patients who did not have information on the size of their primary tumor were excluded. The following data were retrospectively reviewed and analyzed: patient demographics, extent of surgery, recurrence, tumor pathology, and histologic parameters, including tumor size, follicular variant, multifocality, capsular invasion,
Results
We identified 243 patients with PTC who were treated by TT or CT at the University of Wisconsin. Of these 243 patients, 228 (94%) had available information on the size of their primary tumor and were included in this investigation. The average age at diagnosis of the entire cohort was 45 years, and the majority (170 [75%]) were female (Table 1). The proportion of patients with follicular variants of PTC was 20% (46 of 228). In addition, one quarter of all patients (57 of 228) had cervical lymph
Comments
The optimal extent of surgical resection for PTC remains a topic of debate. Although consensus guidelines recommend TT for PTC ≥1 cm, the treatment of papillary microcarcinoma (PMC) is still controversial.12 Furthermore, the role of CT for tumors <1 cm is undefined. In this study, we examined a cohort of 228 patients who underwent TT or CT at the University of Wisconsin from May 1994 to January 2007. We report a similar rate of contralateral PTC for patients with primary tumors ≥1, <1, and <.5
Acknowledgments
This work was supported by the American College of Surgeons Resident Research Scholarship and NIH Grant T32 CA009614 Physician Scientist Training in Cancer Medicine.
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2019, Surgical Clinics of North AmericaCitation Excerpt :This group further demonstrated that pathologic examination of the entire gland as opposed to representative sections significantly increases the incidence of contralateral disease, which was present in 71% of patients.21 The presence of multifocality in 1 lobe has also been shown to be a risk factor for papillary thyroid cancer in the contralateral lobe and is unrelated to tumor size.21,22 The European Society of Endocrine Surgeons consensus statement recommends total thyroidectomy in the setting of multifocality to reduce the risk of local recurrence.19
Multifocality of papillary thyroid carcinoma as a risk factor for disease recurrence
2019, Oral OncologyCitation Excerpt :In addition, the American Joint Committee on Cancer (AJCC) has recently updated the tumor-node-metastasis (TNM) staging system (8th edition) by significantly changing the age-at-diagnosis cut-off to 55 years, and minor extrathyroidal extension and upper mediastinal lymph node (LN) involvement to downstaging [9]. Tumors with two or more foci (multifocality) and bilateral location (bilaterality) frequently arise in the thyroid gland, with the prevalence of multifocality ranging from 32% to 39% [11–13] and that of bilaterality ranging from 13% to 56% [14–17]. Several studies have shown that multifocality and bilaterality are associated with an increased risk of disease recurrence and overall mortality [12,18–20].