Servicio de Cirugía General y del Aparato Digestivo.
Servicio de Anatomía Patológica.
Cir Cir. 2020;88(5):576-583. doi: 10.24875/CIRU.20001560.
The incidence of papillary thyroid microcarcinoma (PTMC) is increasing.
To analyze the long-term prognosis of PTMC.
Study population: patients with a histopathological diagnosis of PTMC (size ≤ 1 cm) treated according to the risk of recurrence of the Latin American Thyroid Society. Inclusion criteria: minimum follow-up of 2 years, availability of histopathological samples, and treatment compliance. Exclusion criteria: previous thyroid surgery, other synchronous malignancies or ectopic location of the PTMC. Study variables: persistences, recurrences and mortality.
Based on the risk of recurrence, PTMC has very low risk in 65.2% (n = 105), low risk in 17.4% (n = 28) and high risk in 17.4% (n = 28). In high risk patients, total thyroidectomy was performed in all cases, cervical lymphadenectomy in 57,1% (n = 16) and metabolic therapy with I in all cases. During a mean follow-up of 119,8 ± 65 months, 0.6% (n = 1) of recurrences took place. Risk factors associated to recurrence were not identified. No patient died due to MCPT.
PTMC treated based on its risk of recurrence has a good long-term prognosis, without persistences, with a low number of recurrences and absence of disease-associated mortality.
甲状腺微小乳头状癌（PTMC）的发病率正在增加。
分析 PTMC 的长期预后。
研究人群：根据拉丁美洲甲状腺学会（LATS）复发风险接受治疗的组织学诊断为 PTMC（大小≤1cm）的患者。纳入标准：至少随访 2 年，有组织病理学样本，以及治疗依从性。排除标准：既往甲状腺手术、其他同步恶性肿瘤或 PTMC 异位。研究变量：持续存在、复发和死亡率。
根据复发风险，PTMC 极低危者占 65.2%（n=105），低危者占 17.4%（n=28），高危者占 17.4%（n=28）。高危患者均行甲状腺全切除术，57.1%（n=16）行颈淋巴结清扫术，所有患者均行 I 代谢治疗。中位随访 119.8±65 个月，有 0.6%（n=1）患者发生复发。未确定与复发相关的危险因素。无患者因 MCPT 而死亡。
根据复发风险对 PTMC 进行治疗，具有良好的长期预后，无持续存在，复发数量少，无疾病相关死亡率。
