Determinants of recurrence in patients with papillary thyroid microcarcinoma

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 459-496-Thyroid Neoplasia & Case Reports
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-479
Arzu Gedik1, Tevfik Demir2, Merve Yilmaz2, Ozhan Ozdogan2, Serkan Abdullah Yener2, Firat Bayraktar3, Sevinc Eraslan2, Merih Guray Durak2, Ahmet Omer Ikiz4, Mehmet Ali Kocdor2, Tulay Canda2 and Abdurrahman Comlekci*5
1Dokuz Eylul Universitesi Tip Fak, Izmir, Turkey, 2Dokuz Eylul University Medical School, Izmir, Turkey, 3Dokuz Eylul Univ Med Schl, Izmir, Turkey, 4Dokuz Eylul University Medical School, Izmir, 5Dokuz Eylul Univ Med Sch, Izmir, Turkey
Background: Papillary thyroid microcarcinomas (PTMC) are generally indolent low-risk

tumors, but rarely show a more aggressive course.

Objective: We aimed to figure out the clinicopathological features of PTMC and to identify determinants of recurrence in the disease course.

Design: Data from the medical records of  patients with PTMC followed in our instutition over a 25 year period were retrospectively analyzed.

Results: Overall, 368 patients (82 % female) with a mean age at diagnosis of 46±12years and a follow-up duration of 5.2±4.5 (0-24) years were included. Hyperthyrodism was noted in 27% of patients at initial presentation whereas Hashimoto’s thyroiditis was present in 22 %. The mean tumor diameter was 5.4± 2.8 milimeters (mm). Multifocal disease was present in 46% (unilateral 21%, bilateral 25%). Classical and follicular variants were the most common subtypes (69 and 25%, respectively). The prevalance of capsular invasion, lymphovascular invasion, lymph node metastasis and distant metastasis were 4.6, 6.3, 4.9 and 0.8% respectively. 42% of the patients recieved radioactive iodine ablation therapy. Recurrence of the disease were present in 10 patients (2,7%). Capsular invasion, lymph node metastasis, and recurrence were significantly higher in the patients with multifocal disease and in those with a tumor diameter greater than 5 milimeters. In the logistic regression analysis, multifocality [p<0.05, Odds ratio:6.447 (CI:1.082-38.428)] and tumor diameter [p<0.05, Odds ratio:1.329 (CI:1.007-1.755)] were found to be the major determinants of disease recurrence.

Conclusions: Multifocality and tumor diameter appears to have predictive value for disease recurrence in PTMC. Despite the favorable prognosis of the disease, we recommend careful lifelong follow-up of the patients, especially those with multifocal disease and larger tumor diameter.

Disclosure: AC: Consultant, Novartis Pharmaceuticals, Speaker, Novartis Pharmaceuticals, Speaker, Sanofi, Consultant, Sanofi, Speaker, Astra Zeneca, Speaker, Bristol-Myers Squibb, Consultant, Novo Nordisk, Speaker, Novo Nordisk, Speaker, Eli Lilly & Company. Nothing to Disclose: AG, TD, MY, OO, SAY, FB, SE, MG, AOI, MAK, TC

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm