BACKGROUND: Although papillary thyroid carcinoma (PTC) generally has an indolent nature, massive extrathyroid extension (Ex) and clinical lateral node metastasis (N1b) are prominent predictors of a dire prognosis. However, it remains unknown whether these factors affect patient prognosis with uniformity. In this study, we investigated the relationships between the prognostic impact of these factors and carcinoma size. METHODS: A total of 5,917 patients who underwent initial and curative surgery for PTC between 1987 and 1995 were enrolled in this study. After dividing these patients into four subsets based on tumor size--≦1.0 cm, 1.1-2.0 cm, 2.1-3.0 cm, and >3.0 cm--we investigated the prognostic impacts of Ex and N1b in each subset. RESULTS: Relative risk (RR) of disease-free survival (DFS) of N1b was the highest in the subset ≦1.0 cm and decreased with tumor size. RR of Ex was smaller in carcinoma ≦3.0 cm but larger in carcinoma >3.0 cm compared with that of N1b in the respective subsets. On multivariate analysis, N1b was a more important prognostic factor than Ex in carcinoma ≦3.0 cm, but the prognostic impacts of these two factors were reversed in carcinoma >3.0 cm. Similar findings were obtained in analyses for cause-specific survival (CSS) and prognostic value of N1b was more significant in carcinoma ≦3.0 cm but less significant in carcinoma >3.0 cm than that of Ex. CONCLUSIONS: The prognostic values of Ex and N1b vary with tumor size in PTC. It is important for physicians to pay attention to tumor size when evaluating the prognostic impact of these two prominent factors.
BACKGROUND: Although papillary thyroid carcinoma (PTC) generally has an indolent nature, massive extrathyroid extension (Ex) and clinical lateral node metastasis (N1b) are prominent predictors of a dire prognosis. However, it remains unknown whether these factors affect patient prognosis with uniformity. In this study, we investigated the relationships between the prognostic impact of these factors and carcinoma size. METHODS: A total of 5,917 patients who underwent initial and curative surgery for PTC between 1987 and 1995 were enrolled in this study. After dividing these patients into four subsets based on tumor size--≦1.0 cm, 1.1-2.0 cm, 2.1-3.0 cm, and >3.0 cm--we investigated the prognostic impacts of Ex and N1b in each subset. RESULTS: Relative risk (RR) of disease-free survival (DFS) of N1b was the highest in the subset ≦1.0 cm and decreased with tumor size. RR of Ex was smaller in carcinoma ≦3.0 cm but larger in carcinoma >3.0 cm compared with that of N1b in the respective subsets. On multivariate analysis, N1b was a more important prognostic factor than Ex in carcinoma ≦3.0 cm, but the prognostic impacts of these two factors were reversed in carcinoma >3.0 cm. Similar findings were obtained in analyses for cause-specific survival (CSS) and prognostic value of N1b was more significant in carcinoma ≦3.0 cm but less significant in carcinoma >3.0 cm than that of Ex. CONCLUSIONS: The prognostic values of Ex and N1b vary with tumor size in PTC. It is important for physicians to pay attention to tumor size when evaluating the prognostic impact of these two prominent factors.
Authors: Bryan R Haugen; Erik K Alexander; Keith C Bible; Gerard M Doherty; Susan J Mandel; Yuri E Nikiforov; Furio Pacini; Gregory W Randolph; Anna M Sawka; Martin Schlumberger; Kathryn G Schuff; Steven I Sherman; Julie Ann Sosa; David L Steward; R Michael Tuttle; Leonard Wartofsky Journal: Thyroid Date: 2016-01 Impact factor: 6.568
Authors: G Sapuppo; F Palermo; M Russo; M Tavarelli; R Masucci; S Squatrito; R Vigneri; G Pellegriti Journal: J Endocrinol Invest Date: 2017-06-23 Impact factor: 4.256
Authors: Henning Dralle; Thomas J Musholt; Jochen Schabram; Thomas Steinmüller; Andreja Frilling; Dietmar Simon; Peter E Goretzki; Bruno Niederle; Christian Scheuba; Thomas Clerici; Michael Hermann; Jochen Kußmann; Kerstin Lorenz; Christoph Nies; Peter Schabram; Arnold Trupka; Andreas Zielke; Wolfram Karges; Markus Luster; Kurt W Schmid; Dirk Vordermark; Hans-Joachim Schmoll; Reinhard Mühlenberg; Otmar Schober; Harald Rimmele; Andreas Machens Journal: Langenbecks Arch Surg Date: 2013-03-03 Impact factor: 3.445
Authors: Ronald Ghossein; Justine A Barletta; Martin Bullock; Sarah J Johnson; Kennichi Kakudo; Alfred K Lam; Mufaddal T Moonim; David N Poller; Giovanni Tallini; R Michael Tuttle; Bin Xu; Anthony J Gill Journal: Hum Pathol Date: 2020-09-10 Impact factor: 3.466