Background: Papillary microcarcinoma (PMC) is increasing in incidence because of diagnosis by ultrasound-guided fine-needle aspiration cytology.
Methods: Between January 1966 and December 1995, we treated 6019 patients with papillary cancer; among them, 2070 patients with PMC were studied.
Results: PMC is essentially very similar to papillary cancer that is 11 mm or larger and has a very good prognosis. Smaller tumors and younger patients have a better prognosis. Among PMC, larger tumors (6-10 mm) recur in 14% at 35 years compared with 3.3% in patients with smaller tumors. Patients older than 55 years have recurrence in 40% at 30 years, with a worse prognosis than younger patients who have a recurrence rate of less than 10%. Extracapsular invasion by the primary tumor also has a higher recurrence rate. The majority of recurrences are in the neck. Therefore, annual ultrasound of the neck is effective for recurrence surveillance.
Conclusion: Papillary microcarcinoma is similar to larger papillary carcinomas with tumor characteristics and age-based recurrence rate that extends for many years, justifying long surveillance after surgery.
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http://dx.doi.org/10.1007/s00268-007-9453-0 | DOI Listing |
Am J Otolaryngol
December 2024
Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel; Faculty of Medicine, Technion, Haifa, Israel.
Objective: Given the good prognosis of low-risk papillary thyroid microcarcinomas (lrPTMCs), accurate risk stratification is valuable to optimize management: active surveillance (AS) vs. hemithyroidectomy (HT). BRAF positive lrPTMC is associated with increased recurrence risk; hence, AS was suggested for mutation-negative lrPTMC.
View Article and Find Full Text PDFGland Surg
November 2024
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Background: Thyroid cancer is one of the most common endocrine tumors and preoperative diagnosis of thyroid follicular neoplasm (FN) is challenging. Commonly used examination methods have difficulty in distinguishing thyroid cancer from other follicular lesions. At the same time, with the recently released World Health Organization (WHO) guidelines, the risk classification of FNs of the thyroid is a new enlightenment for clinicians in the diagnosis and treatment.
View Article and Find Full Text PDFActive surveillance (AS) has been widely adopted as an alternative to immediate surgery owing to the indolent nature and favorable outcomes of papillary thyroid microcarcinoma (PTMC). AS is generally recommended for tumors measuring ≤1 cm without aggressive cytological subtypes, risk of gross extrathyroidal extension (ETE), lymph node metastasis (LNM), or distant metastasis. AS requires careful patient selection based on various patient and tumor characteristics, and ultrasound (US) findings.
View Article and Find Full Text PDFEndocr Connect
December 2024
S Xu, Endocrine and Diabetes Center, Nanjing University of Chinese Medicine, Nanjing, China.
Objective: To evaluate the therapeutic effects of microwave ablation (MWA) versus surgery in treating low-risk papillary thyroid microcarcinoma (PTMC), and to assess recurrence-free survival (RFS) in patients with and without the BRAFV600E mutation.
Methods: Totally 158 patients with low-risk PTMC treated with MWA and 288 patients who underwent surgical treatment were retrospectively analyzed. Local tumor progression (LTP), RFS, and adverse events associated with both treatments were monitored.
Pak J Med Sci
December 2024
Ibrahim Altedlawi Albalawi, Professor of Surgical Oncology, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia.
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