Rasmus Reinke1, Jes Sloth Mathiesen2, Stine Rosenkilde Larsen3, Christoffer Holst Hahn4, Henrik Baymler Pedersen5, Jens Bentzen6, Sten Schytte7, Christian Godballe8, Stefano Christian Londero9. 1. Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Denmark. Electronic address: reinke91@icloud.com. 2. Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Denmark. Electronic address: Jes_Mathiesen@yahoo.dk. 3. Department of Pathology, Odense University Hospital, Denmark. Electronic address: Stine.rosenkilde.larsen@rsyd.dk. 4. Department of ENT Head & Neck Surgery, Copenhagen University Hospital, Denmark. Electronic address: christoffer.holst.hahn.01@regionh.dk. 5. Department of ENT Head & Neck Surgery, Aalborg University Hospital, Denmark. Electronic address: hebp@rn.dk. 6. Department of Oncology, Herlev Hospital, Denmark. Electronic address: jens.bentzen@regionh.dk. 7. Department of ENT Head & Neck Surgery, Aarhus University Hospital, Denmark. Electronic address: sten.schytte@aarhus.rm.dk. 8. Department of ORL Head & Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Denmark. Electronic address: christian.godballe@rsyd.dk. 9. Department of ENT Head & Neck Surgery, Aarhus University Hospital, Denmark. Electronic address: stelon@rm.dk.
Abstract
BACKGROUND: Incidental and non-incidental papillary microcarcinomas (PMC) are associated with different outcomes and treatment options may vary. The least favourable outcome is typically seen when carcinoma is suspected prior to surgery. Only a few studies have addressed the prognosis based on the way of detection for PMC, and they have been limited to retrospective single-center studies. We hypothesize that the "way of detection" may predict prognosis. The aim was to calculate the incidence and outcome of PMC based on the way of detection and to identify patients that may be suitable for active surveillance. METHOD: This national cohort study consists of 803 patients diagnosed with PMC in Denmark from 1996 to 2015. Patients were identified from the DATHYRCA database and allocated into groups according to the way of detection leading to surgery: Incidental at surgery (n = 527), non-incidental with symptoms suspected from the index tumor (n = 134) and non-incidental with symptoms suspected from a metastasis (n = 142). RESULTS: Age-standardized incidence rates increased from 0.35 per 100,000 per year in 1996 to 1.19 per 100,000 per year in 2015. A significant rise in incidence was found for both the incidental group and non-incidental group with symptoms suspected from a metastasis. Recurrence free survival was significantly worse for patients with suspicion of metastasis prior to surgery than patient groups without. No difference in mortality was found between groups. CONCLUSION: PMC patients without suspicion of metastasis have the same low risk of recurrence as incidental cases and may be candidates for active surveillance.
BACKGROUND: Incidental and non-incidental papillary microcarcinomas (PMC) are associated with different outcomes and treatment options may vary. The least favourable outcome is typically seen when carcinoma is suspected prior to surgery. Only a few studies have addressed the prognosis based on the way of detection for PMC, and they have been limited to retrospective single-center studies. We hypothesize that the "way of detection" may predict prognosis. The aim was to calculate the incidence and outcome of PMC based on the way of detection and to identify patients that may be suitable for active surveillance. METHOD: This national cohort study consists of 803 patients diagnosed with PMC in Denmark from 1996 to 2015. Patients were identified from the DATHYRCA database and allocated into groups according to the way of detection leading to surgery: Incidental at surgery (n = 527), non-incidental with symptoms suspected from the index tumor (n = 134) and non-incidental with symptoms suspected from a metastasis (n = 142). RESULTS: Age-standardized incidence rates increased from 0.35 per 100,000 per year in 1996 to 1.19 per 100,000 per year in 2015. A significant rise in incidence was found for both the incidental group and non-incidental group with symptoms suspected from a metastasis. Recurrence free survival was significantly worse for patients with suspicion of metastasis prior to surgery than patient groups without. No difference in mortality was found between groups. CONCLUSION: PMC patients without suspicion of metastasis have the same low risk of recurrence as incidental cases and may be candidates for active surveillance.
Authors: Claudio R Cernea; Leandro Luongo Matos; Cecília Eugênio; Giovanna Mattos Ferreira; Yasmin Sa Cerqueira; Ana Kober N Leite; Felipe A B Vanderlei; Dorival de Carlucci; Renato N Gotoda; Flávio C Hojaij; Vergilius J F Araújo-Filho Journal: Curr Oncol Rep Date: 2022-01-21 Impact factor: 5.075