Department of Medical Science, College of Medicine, Chungnam National University, Daejeon, Republic of Korea.
Department of Otolaryngology-Head and Neck Surgery, Research Institute for Medical Science, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
Eur J Surg Oncol. 2018 Nov;44(11):1754-1759. doi: 10.1016/j.ejso.2018.05.009. Epub 2018 Jun 12.
Extrathyroidal extension (ETE) is a risk factor for poor papillary thyroid carcinoma (PTC) outcomes. However, the clinical significance of ETE according to primary tumor size has not been well-established. The purpose of this study was to compare differences in clinical outcomes, according to the presence and extent of ETE, between different primary tumor size groups.
In total, 381 patients with PTC underwent total thyroidectomy with or without lymph node (LN) dissection from 2004 to 2010. We divided the patients into two groups according to primary tumor size: ≤ 1 cm or >1 cm. Each group was further divided into subgroups according to the presence of ETE (ETE vs. no ETE) and degree of ETE (microscopic ETE vs. macroscopic ETE). The clinicopathological features and rate of recurrence during follow-up were compared among groups.
Among the PTC patients with primary tumors >1 cm, patients with ETE had a higher recurrence rate than those without ETE, and only macroscopic ETE affected recurrence in patients with PTC > 1 cm (P < 0.05). However, there was no significant difference in recurrence rates between those without ETE and those with microscopic ETE (P = 0.100). When the primary tumor size was less than 1 cm, there were no difference in recurrence rates between the groups with or without ETE, or between the groups with microscopic and macroscopic ETE (P > 0.05).
Our data suggests that the presence and degree of ETE may be associated with PTC outcome based on primary tumor size.
甲状腺外侵犯（ETE）是甲状腺乳头状癌（PTC）不良预后的一个危险因素。然而，根据原发肿瘤大小，ETE 的临床意义尚未得到很好的确定。本研究的目的是比较不同原发肿瘤大小组中，根据 ETE 的存在和程度，临床结局的差异。
本研究共纳入了 2004 年至 2010 年间行甲状腺全切除术加或不加淋巴结清扫的 381 例 PTC 患者。我们根据原发肿瘤大小将患者分为两组：≤1cm 或>1cm。每组根据 ETE 的存在（ETE 与无 ETE）和 ETE 的程度（显微镜下 ETE 与大体 ETE）进一步分为亚组。比较各组之间的临床病理特征和随访期间的复发率。
在原发肿瘤>1cm 的 PTC 患者中，有 ETE 的患者复发率高于无 ETE 的患者，只有大体 ETE 影响了原发肿瘤>1cm 的 PTC 患者的复发（P<0.05）。然而，无 ETE 与显微镜下 ETE 患者之间的复发率无显著差异（P=0.100）。当原发肿瘤<1cm 时，有无 ETE 或显微镜下和大体 ETE 的患者之间，复发率无差异（P>0.05）。
我们的数据表明，根据原发肿瘤大小，ETE 的存在和程度可能与 PTC 结局相关。
