Seo Ki Kim1, Inhye Park1, Jung-Woo Woo2, Jun Ho Lee3, Jun-Ho Choe1, Jung-Han Kim1, Jee Soo Kim1. 1. 1 Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, South Korea . 2. 2 Department of Surgery, Changwon Gyeongsang National University Hospital, Gyeongsang National University School of Medicine , Changwon, South Korea . 3. 3 Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine , Changwon, South Korea .
Abstract
BACKGROUND: In the 2015 American Thyroid Association guidelines, either lobectomy or total thyroidectomy was recommended for thyroid cancer <4 cm without extrathyroidal extension (ETE) and lymph node (LN) metastasis. Therefore, the purpose of this study was to investigate factors predictive of bilaterality in papillary thyroid carcinoma (PTC) patients with tumor size <4 cm. METHODS: This study retrospectively reviewed 3296 conventional PTC patients who underwent total thyroidectomy with central neck dissection and/or lateral neck dissection between January 2008 and June 2015. RESULTS: In overall conventional PTC patients, per 10-year age increment (adjusted odds ratio [OR] = 1.153, p < 0.001), BRAF mutation positivity (adjusted OR = 1.447, p = 0.002) and multifocality (adjusted OR = 3.895, p < 0.001) were independent predictors for bilaterality. In conventional PTC patients with tumor size 1-4 cm, per 10-year age increment (adjusted OR = 1.289, p < 0.001), BRAF mutation positivity (adjusted OR = 1.560, p = 0.012), multifocality (adjusted OR = 4.220, p < 0.001), and N1b (adjusted OR = 1.570, p = 0.007) were independent predictors for bilaterality. In conventional PTC patients with tumor size <1 cm, BRAF mutation positivity (adjusted OR = 1.327, p = 0.042) and multifocality (adjusted OR = 3.530, p < 0.001) were found to be independent predictors for bilaterality. CONCLUSIONS: When multifocality and BRAF mutation positivity are observed in PTC patients with tumor size <4 cm, total thyroidectomy may be considered. If lobectomy is performed in PTC patients with multifocality and BRAF mutation positivity, meticulous follow-up is needed to detect hidden malignancies in the contralateral lobe.
BACKGROUND: In the 2015 American Thyroid Association guidelines, either lobectomy or total thyroidectomy was recommended for thyroid cancer <4 cm without extrathyroidal extension (ETE) and lymph node (LN) metastasis. Therefore, the purpose of this study was to investigate factors predictive of bilaterality in papillary thyroid carcinoma (PTC) patients with tumor size <4 cm. METHODS: This study retrospectively reviewed 3296 conventional PTC patients who underwent total thyroidectomy with central neck dissection and/or lateral neck dissection between January 2008 and June 2015. RESULTS: In overall conventional PTC patients, per 10-year age increment (adjusted odds ratio [OR] = 1.153, p < 0.001), BRAF mutation positivity (adjusted OR = 1.447, p = 0.002) and multifocality (adjusted OR = 3.895, p < 0.001) were independent predictors for bilaterality. In conventional PTC patients with tumor size 1-4 cm, per 10-year age increment (adjusted OR = 1.289, p < 0.001), BRAF mutation positivity (adjusted OR = 1.560, p = 0.012), multifocality (adjusted OR = 4.220, p < 0.001), and N1b (adjusted OR = 1.570, p = 0.007) were independent predictors for bilaterality. In conventional PTC patients with tumor size <1 cm, BRAF mutation positivity (adjusted OR = 1.327, p = 0.042) and multifocality (adjusted OR = 3.530, p < 0.001) were found to be independent predictors for bilaterality. CONCLUSIONS: When multifocality and BRAF mutation positivity are observed in PTC patients with tumor size <4 cm, total thyroidectomy may be considered. If lobectomy is performed in PTC patients with multifocality and BRAF mutation positivity, meticulous follow-up is needed to detect hidden malignancies in the contralateral lobe.
Entities:
Keywords:
BRAF mutation; bilaterality; multifocality; papillary thyroid carcinoma; total thyroidectomy
Authors: Liu Yihao; Li Shuo; Xi Pu; Wang Zipeng; Sun Hanlin; Chang Qungang; Wang Yongfei; Yin Detao Journal: Int J Endocrinol Date: 2022-06-28 Impact factor: 2.803
Authors: Amjad O Aljohani; Reyan H Merdad; Anas I Alserif; Layan S Alhemayed; Noor Z Farsi; Thamer A Alsufyani; Haddad H Alkaf; Ameen Z Alherabi; Sherif K Abdelmonim; Mohammad A Alessa Journal: Ann Med Surg (Lond) Date: 2021-03-22