Title | Extrathyroidal extension is not all equal: Implications of macroscopic versus microscopic extent in papillary thyroid carcinoma. |
Publication Type | Journal Article |
Year of Publication | 2008 |
Authors | Arora N, Turbendian HK, Scognamiglio T, Wagner PL, Goldsmith SJ, Zarnegar R, Fahey TJ |
Journal | Surgery |
Volume | 144 |
Issue | 6 |
Pagination | 942-7; discussion 947-8 |
Date Published | 2008 Dec |
ISSN | 1532-7361 |
Keywords | Adenocarcinoma, Follicular, Adenocarcinoma, Papillary, Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Retrospective Studies, Thyroid Neoplasms, Thyroidectomy, Young Adult |
Abstract | BACKGROUND: Extrathyroidal extension (ETE) is a risk factor for recurrence of papillary thyroid carcinoma (PTC). Although initial data supporting this was based on gross ETE noted at surgery, current treatment regimens group patients with microscopic ETE-identified only on histopathology-similarly to those with macroscopic (gross) ETE. This study was designed to assess the influence of microscopic ETE on disease recurrence. METHODS: Retrospective analysis of 212 patients undergoing thyroidectomy for PTC between 1995 and 2004 with minimum 3-year follow-up was conducted. RESULTS: Of 212 patients, 71 had ETE; 32% were macroscopic and 68% microscopic. Patient demographics, tumor variables, and adjuvant therapy were similar between both ETE groups. Recurrence rates were 52% for macroscopic ETE, 21% for microscopic ETE, and 13% without ETE. On multivariate analysis, patients with macroscopic ETE had a 6.4-fold increased relative risk of recurrence compared with patients with microscopic ETE (P < .02; 95% confidence interval, 1.6-25.9) and a significantly decreased disease-free survival (DFS). Furthermore, patients with microscopic ETE had neither a significantly increased risk of recurrence nor different DFS compared with patients without ETE. CONCLUSION: Macroscopic ETE has a higher incidence of disease recurrence than microscopic ETE, implying they should be considered separately when devising adjuvant treatment regimens. The significance of microscopic ETE is undetermined. |
DOI | 10.1016/j.surg.2008.07.023 |
Alternate Journal | Surgery |
PubMed ID | 19041001 |
Related Faculty:
Theresa Scognamiglio, M.D.