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Management of Clinically Solitary Papillary Thyroid Carcinoma Patients According to Risk-Scoring Model for Contralateral Occult Carcinoma
OBJECTIVE: The aim of this study was to investigate risk factors of occult carcinoma in clinically solitary papillary thyroid carcinoma (PTC) patients, and to put emphasis on the predictive value of risk-scoring model to determine the optimal scope of surgery METHODS: A total of 573 clinically solit...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7578423/ https://www.ncbi.nlm.nih.gov/pubmed/33133013 http://dx.doi.org/10.3389/fendo.2020.553577 |
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author | Feng, Jia-Wei Ye, Jing Wu, Wan-Xiao Pan, Hua Qin, An-Cheng Jiang, Yong Wu, Bao-Qiang |
author_facet | Feng, Jia-Wei Ye, Jing Wu, Wan-Xiao Pan, Hua Qin, An-Cheng Jiang, Yong Wu, Bao-Qiang |
author_sort | Feng, Jia-Wei |
collection | PubMed |
description | OBJECTIVE: The aim of this study was to investigate risk factors of occult carcinoma in clinically solitary papillary thyroid carcinoma (PTC) patients, and to put emphasis on the predictive value of risk-scoring model to determine the optimal scope of surgery METHODS: A total of 573 clinically solitary PTC patients who underwent total thyroidectomy (TT) from two hospitals were retrospectively analyzed. Clinicopathological features were collected, univariate and multivariate analyses were performed to determine risk factors of occult carcinoma. The Cox proportional hazards model was used to analyze the risk factors of recurrence. A scoring model was constructed according to independent risk factors of contralateral occult carcinoma. RESULTS: 19.2% of clinically solitary PTC patients had occult carcinoma, among which 3.7% patients had ipsilateral occult carcinoma and 15.5% patients had contralateral occult carcinoma. Factors such as male, the presence of benign nodule, and vascular invasion increase the risk of ipsilateral occult carcinoma. Tumor size >1 cm, the presence of benign nodule, extrathyroidal extension, central lymph node metastasis, lateral lymph node metastasis are independent predictors of contralateral occult carcinoma. Contralateral occult carcinoma is the independent predictor of recurrence. A 10-point risk-scoring model was established to predict the contralateral occult carcinoma in clinically solitary PTC patients. CONCLUSION: Lobectomy is sufficient for clinically solitary PTC patients with risk factors of ipsilateral occult carcinoma. For clinically solitary PTC patients with score ≥4, careful preoperative evaluations are required to rule out the contralateral occult carcinoma. Even if contralateral occult carcinoma is not detected preoperatively, TT is recommended for high-risk patients. |
format | Online Article Text |
id | pubmed-7578423 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-75784232020-10-30 Management of Clinically Solitary Papillary Thyroid Carcinoma Patients According to Risk-Scoring Model for Contralateral Occult Carcinoma Feng, Jia-Wei Ye, Jing Wu, Wan-Xiao Pan, Hua Qin, An-Cheng Jiang, Yong Wu, Bao-Qiang Front Endocrinol (Lausanne) Endocrinology OBJECTIVE: The aim of this study was to investigate risk factors of occult carcinoma in clinically solitary papillary thyroid carcinoma (PTC) patients, and to put emphasis on the predictive value of risk-scoring model to determine the optimal scope of surgery METHODS: A total of 573 clinically solitary PTC patients who underwent total thyroidectomy (TT) from two hospitals were retrospectively analyzed. Clinicopathological features were collected, univariate and multivariate analyses were performed to determine risk factors of occult carcinoma. The Cox proportional hazards model was used to analyze the risk factors of recurrence. A scoring model was constructed according to independent risk factors of contralateral occult carcinoma. RESULTS: 19.2% of clinically solitary PTC patients had occult carcinoma, among which 3.7% patients had ipsilateral occult carcinoma and 15.5% patients had contralateral occult carcinoma. Factors such as male, the presence of benign nodule, and vascular invasion increase the risk of ipsilateral occult carcinoma. Tumor size >1 cm, the presence of benign nodule, extrathyroidal extension, central lymph node metastasis, lateral lymph node metastasis are independent predictors of contralateral occult carcinoma. Contralateral occult carcinoma is the independent predictor of recurrence. A 10-point risk-scoring model was established to predict the contralateral occult carcinoma in clinically solitary PTC patients. CONCLUSION: Lobectomy is sufficient for clinically solitary PTC patients with risk factors of ipsilateral occult carcinoma. For clinically solitary PTC patients with score ≥4, careful preoperative evaluations are required to rule out the contralateral occult carcinoma. Even if contralateral occult carcinoma is not detected preoperatively, TT is recommended for high-risk patients. Frontiers Media S.A. 2020-10-08 /pmc/articles/PMC7578423/ /pubmed/33133013 http://dx.doi.org/10.3389/fendo.2020.553577 Text en Copyright © 2020 Feng, Ye, Wu, Pan, Qin, Jiang and Wu http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology Feng, Jia-Wei Ye, Jing Wu, Wan-Xiao Pan, Hua Qin, An-Cheng Jiang, Yong Wu, Bao-Qiang Management of Clinically Solitary Papillary Thyroid Carcinoma Patients According to Risk-Scoring Model for Contralateral Occult Carcinoma |
title | Management of Clinically Solitary Papillary Thyroid Carcinoma Patients According to Risk-Scoring Model for Contralateral Occult Carcinoma |
title_full | Management of Clinically Solitary Papillary Thyroid Carcinoma Patients According to Risk-Scoring Model for Contralateral Occult Carcinoma |
title_fullStr | Management of Clinically Solitary Papillary Thyroid Carcinoma Patients According to Risk-Scoring Model for Contralateral Occult Carcinoma |
title_full_unstemmed | Management of Clinically Solitary Papillary Thyroid Carcinoma Patients According to Risk-Scoring Model for Contralateral Occult Carcinoma |
title_short | Management of Clinically Solitary Papillary Thyroid Carcinoma Patients According to Risk-Scoring Model for Contralateral Occult Carcinoma |
title_sort | management of clinically solitary papillary thyroid carcinoma patients according to risk-scoring model for contralateral occult carcinoma |
topic | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7578423/ https://www.ncbi.nlm.nih.gov/pubmed/33133013 http://dx.doi.org/10.3389/fendo.2020.553577 |
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