Kyorim Back1, Seo Ki Kim2, Young Jun Chai3, Jung-Han Kim1, Jun-Ho Choe1, Jee Soo Kim4. 1. Division of Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 2. Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea. 3. Department of Surgery, Seoul Metropolitan Government- Seoul National University Boramae Medical Center, Seoul, Republic of Korea. 4. Division of Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address: jskim0126@skku.edu.
Abstract
BACKGROUND: The clinical impact of microscopically positive tumor margin in papillary thyroid cancer is not well studied. The aim of this study is to evaluate the clinical importance of a microscopically positive margin for recurrence in papillary thyroid cancer patients and to examine whether recurrence and recurrence-free survival were affected by the location of the positive margin-anterior or posterior. METHODS: We conducted a retrospective cohort study at a single institution. From January 1997 to June 2015,6,293 papillary thyroid cancer patients who underwent total thyroidectomy with or without neck dissection (central and/or lateral) at the Thyroid Cancer Center of Samsung Medical Center (Seoul, South Korea) were included in the analyses. RESULTS: Of the 6,293 papillary thyroid cancer patients, an operative margin was microscopically involved in 313 (5.0%) on final pathologic report. The mean follow-up time was 77.5 months, and locoregional recurrence was observed in 244 (3.9%) patients. The presence of a microscopically positive margin did not increase the risk of locoregional recurrence (adjusted hazard ratio = 1.079, P = .140) after adjustment for other statistically significant factors in the Cox proportional hazard model. In addition, posterior positive margin was not a risk factor for locoregional recurrence as well (adjusted hazard ratio = 1.24, P = .672). In a propensity score-matching analysis, a microscopically positive margin did not increase the risk of locoregional recurrence. CONCLUSION: Microscopic involvement of the operative margin in papillary thyroid cancer patients, whether anteriorly or posteriorly, does not appear be an independent prognostic factor in recurrence-free survival rates.
BACKGROUND: The clinical impact of microscopically positive tumor margin in papillary thyroid cancer is not well studied. The aim of this study is to evaluate the clinical importance of a microscopically positive margin for recurrence in papillary thyroid cancerpatients and to examine whether recurrence and recurrence-free survival were affected by the location of the positive margin-anterior or posterior. METHODS: We conducted a retrospective cohort study at a single institution. From January 1997 to June 2015,6,293 papillary thyroid cancerpatients who underwent total thyroidectomy with or without neck dissection (central and/or lateral) at the Thyroid Cancer Center of Samsung Medical Center (Seoul, South Korea) were included in the analyses. RESULTS: Of the 6,293 papillary thyroid cancerpatients, an operative margin was microscopically involved in 313 (5.0%) on final pathologic report. The mean follow-up time was 77.5 months, and locoregional recurrence was observed in 244 (3.9%) patients. The presence of a microscopically positive margin did not increase the risk of locoregional recurrence (adjusted hazard ratio = 1.079, P = .140) after adjustment for other statistically significant factors in the Cox proportional hazard model. In addition, posterior positive margin was not a risk factor for locoregional recurrence as well (adjusted hazard ratio = 1.24, P = .672). In a propensity score-matching analysis, a microscopically positive margin did not increase the risk of locoregional recurrence. CONCLUSION: Microscopic involvement of the operative margin in papillary thyroid cancerpatients, whether anteriorly or posteriorly, does not appear be an independent prognostic factor in recurrence-free survival rates.
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