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M.D., M.D., M.D., M.D., M.D., M.D., and M.D.: Analysis of Clinicopathologic Features of Papillary Thyroid Microcarcinoma According to Cut-off of Tumor Size
Review Article

Korean J Endocrine Surg 2010;10(3):152-156.

Published online: 18 March 2010

DOI: https://doi.org/10.16956/kjes.2010.10.1.152

Analysis of Clinicopathologic Features of Papillary Thyroid Microcarcinoma According to Cut-off of Tumor Size

Yun-Jung Cho M.D., Dong-Ho Lee M.D., Sang-Chul Lee M.D., Say-Jun Kim M.D., Jung-Koo Kim M.D., Chang-Joon Ahn M.D., Kwan-Ju Lee M.D.

Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea

Copyright © 2010 Korean Journal of Endocrine Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

Although the detected incidence of papillary thyroid microcarcinoma (PTMC) has increased with development of ultrasonography and fine-needle aspiration biopsy, the best treatment has not yet been established. Treatment decisions require information on many factors including lymph node metastasis, extrathyroidal extension, and bilaterality. With this aim, the present study analyzed clinicopathologic features of PTMC according to cut-off of tumor size.

Methods:

The clinicopathologic features of patients with PTMC between January 2007 and December 2009 were reviewed retrospectively from medical records. Patients were divided according to tumors lesser than or equal to cut-off (Group I) and tumors exceeding cut-off (Group II).

Results:

Both capsule invasion and lymphovascular invasion were significantly different at all cut-off diameters (5 ∼9 mm). Central node metastasis revealed a difference in all cut-off values except 8 mm. Extrathyroidal extension differed at all cut-off values except 5 mm. Bilaterality displayed a statistically significantdifference only at the 8 mm cut-off.

Conclusion:

A cut-off of 5 mm represents a safe value to discriminate less aggressive from aggressive treatment for PTMC. (Korean J Endocrine Surg 2010;10:152-156)

Keywords: Papillary thyroid microcarcinoma, Tumor size

REFERENCES

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Table 1.
Clinicopathologic features of papillary thyroid micro
carcinoma  
  Patients (%)
Gender  
Male 18 (5.7)
Female 300 (94.3)
Capsule invasion 120 (37.7)
Extrathyroidal extension 79 (24.8)
Central node metastasis 113 (35.5)
Lymphovascular invasion 112 (35.2)
Type of surgery  
Lobectomy 66 (20.8)
Total thyroidectomy 252 (79.2)
Bilaterality 62 (19.5)
Multifocality 102 (32.1)
Table 2.
Analysis of clinicopathologic features of papillary thyroid microcarcinoma according to 5 mm, 6 mm, and 7 mm cut-off
Patients (%)
5 mm cut-off P value 6 mm cut-off P value 7 mm cut-off P value
Group I Group II Group I Group II Group I Group II
Gender     0.79     0.65     0.44
Male 8 (6.1) 10 (5.4)   11 (6.2) 7 (5.0)   14 (6.3) 4 (4.2)  
Female 124 (93.9) 176 (94.6)   167 (93.8) 133 (95.0)   208 (93.7) 92 (95.8)  
Age (years)     0.02     0.09     0.26
＜45 57 (43.2) 57 (30.6)   71 (39.9) 43 (30.7)   84 (37.8) 30 (31.3)  
≥45s 75 (56.8) 129 (69.4)   107 (60.1) 97 (69.3)   138 (62.2) 66 (68.8)  
Capsule invasion 35 (26.5) 85 (45.7) 0.001 50 (28.1) 70 (50.0) ＜0.001 70 (31.5) 50 (52.1) 0.001
ETE∗ 27 (20.5) 52 (28.0) 0.12 33 (18.5) 46 (32.9) 0.003 46 (20.7) 33 (34.4) 0.01
CN† metastasis 37 (28.0) 76 (40.9) 0.019 52 (29.2) 61 (43.6) 0.008 70 (31.5) 43 (44.8) 0.023
LV‡ invasion 37 (29.8) 75 (41.7) 0.036 50 (29.8) 62 (45.6) 0.004 69 (33.0) 43 (45.3) 0.04
Type of surgery     ＜0.001     0.002     0.003
Lobectomy 41 (31.1) 25 (13.4)   48 (27.0) 18 (12.9)   56 (25.2) 10 (10.4)  
Total thyroidectom my 91 (68.9) 161 (86.6)   130 (73.0) 122 (87.1)   166 (74.8) 86 (89.6)  
Bilaterality§ 18 (19.8) 44 (27.3) 0.181 29 (22.3) 33 (27.0) 0.38 37 (22.3) 25 (29.1) 0.236
Multifocality 33 (25.0) 69 (37.1) 0.023 52 (29.2) 50 (35.7) 0.21 65 (29.3) 37 (38.5) 0.104

∗ Extrathyroidal extension;

† Central node;

‡ Lymphvascular; The case that was not described about lymphovascular invasion was excluded;

§ The patients who underwent lobecotmy were excluded.

Table 3.
Analysis of clinicopathologic features of papillary thyroid microcarcinoma according to 8 mm and 9 mm cut-off
    Patients (%)  
  8 mm cut-off P value 9 mm cut-off P value
  Group I Group II Group I Group II
Gender   0.42   0.28
Male 16 (6.2) 2 (3.4)   17 (6.2) 1 (2.2)  
Female 244 (93.8) 56 (96.6)   256 (93.8) 44 (97.8)  
Age (years)   0.58   0.29
＜45 95 (36.5) 19 (32.8)   101 (37.0) 13 (28.9)  
≥45s 165 (63.5) 39 (67.2)   172 (63.0) 32 (71.1)  
Capsule invasion 88 (33.8) 32 (55.2) 0.002 96 (35.2) 24 (53.3) 0.02
ETE∗ 57 (21.9) 22 (37.9) 0.011 62 (22.7) 17 (37.8) 0.03
CN† metastasis 87 (33.5) 26 (44.8) 0.102 91 (33.3) 22 (48.9) 0.04
LV‡ invasion 84 (34.0) 28 (49.1) 0.03 90 (34.6) 22 (50.0) 0.05
Type of surgery   ＜0.001   0.004
Lobectomy 64 (24.6) 2 (3.4)   64 (23.4) 2 (4.4)  
Total thyroidectomy y 196 (75.4) 56 (96.6)   209 (76.6) 43 (95.6)  
Bilaterality§ 42 (21.4) 20 (35.7) 0.029 48 (23.0) 14 (32.6) 0.18
Multifocality 74 (28.5) 28 (48.3) 0.003 81 (29.7) 21 (46.7) 0.024

∗ Extrathyroidal extension;

† Central node;

‡ Lymphvascular; The case that was not described about lymphovascular invasion was excluded;

§ The patients who underwent lobecotmy were excluded.

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