Hyemi Kwon1,2, Hye-Seon Oh1, Mijin Kim1, Suyeon Park1, Min Ji Jeon1, Won Gu Kim1, Won Bae Kim1, Young Kee Shong1, Dong Eun Song3, Jung Hwan Baek4, Ki-Wook Chung5, Tae Yong Kim1. 1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. 2. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea. 3. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. 4. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea. 5. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
Abstract
Context: Papillary thyroid microcarcinoma (PTMC) usually has an excellent prognosis. Objective: To evaluate the three-dimensional structures of PTMCs, using serial neck ultrasonography (US) in patients under active surveillance. Design and Setting: A retrospective cohort study. Participants: In total, 192 patients diagnosed with PTMC under active surveillance for >1 year were included in a median 30-month follow-up. Changes in tumor size were evaluated not only using the maximal tumor diameter but also the tumor volume. Results: The median age of patients was 51.3 years and 145 patients (76%) were female. The median initial maximal tumor diameter and tumor volume were 5.5 mm and 48.8 mm3, respectively. The tumor size increased in 27 patients (14%); 23 patients showed a tumor volume increase >50% without a maximal diameter increase of ≥3 mm. The other four patients had both an increasing tumor volume and increasing maximal tumor diameter ≥3 mm. One patient (0.5%) had newly appeared cervical lymph node (LN) metastasis at 3 years after the initial diagnosis. There were no significant risk factors associated with increased tumor size, such as age, sex, or Hashimoto thyroiditis. Twenty-four patients (13%) underwent delayed thyroid surgery at a median of 31.2 months and seven (29%) had cervical LN metastasis on pathologic examination. Conclusion: Some PTMCs could grow significantly after a relatively short period of active surveillance. We also found that the change in tumor volume was more sensitive to detect tumor progression than the change in the maximal tumor diameter.
Context:Papillary thyroid microcarcinoma (PTMC) usually has an excellent prognosis. Objective: To evaluate the three-dimensional structures of PTMCs, using serial neck ultrasonography (US) in patients under active surveillance. Design and Setting: A retrospective cohort study. Participants: In total, 192 patients diagnosed with PTMC under active surveillance for >1 year were included in a median 30-month follow-up. Changes in tumor size were evaluated not only using the maximal tumor diameter but also the tumor volume. Results: The median age of patients was 51.3 years and 145 patients (76%) were female. The median initial maximal tumor diameter and tumor volume were 5.5 mm and 48.8 mm3, respectively. The tumor size increased in 27 patients (14%); 23 patients showed a tumor volume increase >50% without a maximal diameter increase of ≥3 mm. The other four patients had both an increasing tumor volume and increasing maximal tumor diameter ≥3 mm. One patient (0.5%) had newly appeared cervical lymph node (LN) metastasis at 3 years after the initial diagnosis. There were no significant risk factors associated with increased tumor size, such as age, sex, or Hashimoto thyroiditis. Twenty-four patients (13%) underwent delayed thyroid surgery at a median of 31.2 months and seven (29%) had cervical LN metastasis on pathologic examination. Conclusion: Some PTMCs could grow significantly after a relatively short period of active surveillance. We also found that the change in tumor volume was more sensitive to detect tumor progression than the change in the maximal tumor diameter.
Authors: Allen S Ho; Michael Luu; Cynthia Zalt; Luc G T Morris; Irene Chen; Michelle Melany; Nabilah Ali; Chrysanta Patio; Yufei Chen; Jon Mallen St-Clair; Glenn D Braunstein; Wendy L Sacks; Zachary S Zumsteg Journal: Thyroid Date: 2019-09-24 Impact factor: 6.568
Authors: Min Ji Jeon; Sung Min Chun; Ji-Young Lee; Kyeong Woon Choi; Deokhoon Kim; Tae Yong Kim; Se Jin Jang; Won Bae Kim; Young Kee Shong; Dong Eun Song; Won Gu Kim Journal: Endocrine Date: 2019-01-15 Impact factor: 3.633
Authors: Giovanni Mauri; Laszlo Hegedüs; Steven Bandula; Roberto Luigi Cazzato; Agnieszka Czarniecka; Oliver Dudeck; Laura Fugazzola; Romana Netea-Maier; Gilles Russ; Göran Wallin; Enrico Papini Journal: Eur Thyroid J Date: 2021-05-25