Treatment and prognostic factors of papillary thyroid microcarcinoma.

OBJECTIVE

To discuss the prognostic factors and outcomes of treatment in patients diagnosed with papillary thyroid microcarcinoma.

DESIGN

Retrospective observational case review.

SETTING

Department of Otorhinolaryngology of the tertiary referral teaching hospital of Parma.

PARTICIPANTS

Ninety-seven patients diagnosed with PTMC and surgically treated between January 1998 and December 2007.

MAIN OUTCOME MEASURES

Clinical and histopathological characteristics of the study group were identified and statistically analysed.

RESULTS

No cancer-related deaths were registered. Incidence of recurrent disease was 9% after a 43 month mean follow-up (range 12-120). Univariate analysis detected that metastases in neck lymph nodes at diagnosis (p = 0.025), a tumour >5 mm in size (p = 0.011), the presence of bilateral tumoural foci (p = 0.007), the presence of capsular invasion (p = 0.001), and the presence of vascular invasion (p = 0.004) were related to recurrent disease. On multivariate analysis, the presence of bilateral tumoural foci (p = 0.030), and the presence of capsular invasion (p = 0.005) were significantly related to tumour recurrence.

CONCLUSION

The prognosis for patients with papillary thyroid microcarcinoma in this series was excellent, with a 100% survival rate and minimal surgical-related morbidity. Nevertheless, approximately 10% of patients developed recurrent disease; aggressive treatment may be justified depending on the presence or absence of prognostic risk factors.