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Abstract
Purpose:
Papillary thyroid microcarcinoma (PTMC) is defined as a papillary thyroid carcinoma ＜10 mm in greatest dimension without palpation. In general, prognosis of PTMC is very favorable. PTMC can present with advanced features like papillary thyroid carcinoma ＞10 mm. Indication of FNAC based only on tumor size is still in debate. Some favor the criteria of a size ＜5 mm without FNAC and some argue for more study of the indication of FNAC according to tumor size. We analyzed the relationship of prognostic factors and number of FNACs prior to surgery for PTMC according to 5 mm size criterion.
Methods:
Three hundred seven patients diagnosed with PTMC after surgery were enrolled. Based on tumor size, patients were divided into group 1 (≤5 mm, n=151) and group 2 (＞5 mm, n=156) and the prognostic factors and number of pre-surgical FNAC procedures were compared.
Results:
There were no significant differences in gender, age, site, accompanying benign disease, multifocality and bilaterality. Group 2 patients displayed more advanced features than group 1 patients concerning capsular invasion, lymph node metastasis and tumor stage. The number of FNAC procedures prior to the decision of surgery was not different in the two groups.
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Table 1.
Clinicopathologic characteristics of the patients
Table 2.
Cancer staging of the patients with age of 45 years and older
| Group 1 (≤5 mm) (n=104) (%) | Group 2 (＞5 mm) (n=108) (%) | P value | |
|---|---|---|---|
| Stage (age≥45) | |||
| I | 61 (58%) | 42 (39%) | ＜0.01 |
| III | 35 (34%) | 44 (41%) | 0.23 |
| IVA | 8 (8%) | 22 (20%) | ＜0.01 |
Table 3.
Number of FNAC∗ prior to decision of surgery by tumor size
Table 4.
Analysis of number of FNAC∗ prior to decision of surgery by according to 6 mm, 5 mm, 4 mm cut-off of tumor size
| Patients (n=197) | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| 6 mm cut-off | P value | 5 mm cut-off | P value | 4 mm cut-off | P value | ||||
| ≥6 mm | ＜6 mm | ≥5 mm | ＜5 mm | ≥4 mm | =3 mm | ||||
| Number of FNAC | 0.61 | 0.31 | 0.53 | ||||||
| 1 | 88 | 83 | 145 | 26 | 151 | 20 | |||
| ＞2 | 12 | 14 | 20 | 6 | 22 | 4 | |||
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