OBJECTIVE: To study the relationship between primary tumour size and the risk of advanced disease features (multifocal or locally invasive disease, lymph-node or distant metastases) in differentiated thyroid carcinoma (DTC). DESIGN: A retrospective chart review study. PATIENTS: The study sample comprised 935 papillary (PTC) and 291 follicular thyroid carcinoma (FTC) patients treated in our hospital from 1978 to 2007. MEASUREMENTS: Kaplan-Meier analyses and log-rank tests were performed to calculate tumour size-adjusted cumulative risk of advanced disease features. RESULTS: Accounting for primary tumour diameter, there were no significant differences in cumulative risks of multifocal carcinoma (P = 0.12) or distant metastases (P = 0.49) between PTC and FTC. PTC showed higher cumulative risks of local invasion (P < 0.0001) or lymph-node metastases (P < 0.0001). The cumulative risk of tumour multifocality increased 5%/cm of primary tumour diameter. The cumulative risk of local invasion or lymph-node metastases in PTC and of distant metastases in DTC increased exponentially at a threshold tumour diameter of 10 mm. In FTC, lymph-node metastases are associated almost exclusively with primary tumours showing extrathyroidal growth. CONCLUSIONS: Starting with a 1 cm primary tumour diameter, increasing tumour size is associated with an exponentially increasing risk of local invasion or lymph-node or distant metastases of DTC. The current classification of carcinomas < 2 cm as T1 is therefore questionable.
OBJECTIVE: To study the relationship between primary tumour size and the risk of advanced disease features (multifocal or locally invasive disease, lymph-node or distant metastases) in differentiated thyroid carcinoma (DTC). DESIGN: A retrospective chart review study. PATIENTS: The study sample comprised 935 papillary (PTC) and 291 follicular thyroid carcinoma (FTC) patients treated in our hospital from 1978 to 2007. MEASUREMENTS: Kaplan-Meier analyses and log-rank tests were performed to calculate tumour size-adjusted cumulative risk of advanced disease features. RESULTS: Accounting for primary tumour diameter, there were no significant differences in cumulative risks of multifocal carcinoma (P = 0.12) or distant metastases (P = 0.49) between PTC and FTC. PTC showed higher cumulative risks of local invasion (P < 0.0001) or lymph-node metastases (P < 0.0001). The cumulative risk of tumour multifocality increased 5%/cm of primary tumour diameter. The cumulative risk of local invasion or lymph-node metastases in PTC and of distant metastases in DTC increased exponentially at a threshold tumour diameter of 10 mm. In FTC, lymph-node metastases are associated almost exclusively with primary tumours showing extrathyroidal growth. CONCLUSIONS: Starting with a 1 cm primary tumour diameter, increasing tumour size is associated with an exponentially increasing risk of local invasion or lymph-node or distant metastases of DTC. The current classification of carcinomas < 2 cm as T1 is therefore questionable.
Authors: Christoph Reiners; Heribert Hänscheid; Markus Luster; Michael Lassmann; Frederik A Verburg Journal: Nat Rev Endocrinol Date: 2011-08-09 Impact factor: 43.330
Authors: Frederik A Verburg; Uwe Mäder; Markus Luster; Heribert Hänscheid; Christoph Reiners Journal: Eur J Nucl Med Mol Imaging Date: 2015-06-13 Impact factor: 9.236
Authors: Frederik A Verburg; Glenn Flux; Luca Giovanella; Douglas van Nostrand; Kristoff Muylle; Markus Luster Journal: Eur J Nucl Med Mol Imaging Date: 2019-10-15 Impact factor: 9.236