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Impact of Multifocality on the Recurrence of Papillary Thyroid Carcinoma

The incidence of thyroid cancer has dramatically increased over the last few decades, and up to 60% of patients have multifocal tumors. However, the prognostic impact of multifocality in patients with papillary thyroid carcinoma (PTC) remains unestablished and controversial. We evaluate whether mult...

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Autores principales: Woo, Joohyun, Kim, Hyeonkyeong, Kwon, Hyungju
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584384/
https://www.ncbi.nlm.nih.gov/pubmed/34768664
http://dx.doi.org/10.3390/jcm10215144
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author Woo, Joohyun
Kim, Hyeonkyeong
Kwon, Hyungju
author_facet Woo, Joohyun
Kim, Hyeonkyeong
Kwon, Hyungju
author_sort Woo, Joohyun
collection PubMed
description The incidence of thyroid cancer has dramatically increased over the last few decades, and up to 60% of patients have multifocal tumors. However, the prognostic impact of multifocality in patients with papillary thyroid carcinoma (PTC) remains unestablished and controversial. We evaluate whether multifocality can predict the recurrence of PTC. A total of 1249 patients who underwent total thyroidectomy for PTC at the Ewha Medical Center between March 2012 and December 2019 were reviewed. In this study, multifocality was found in 487 patients (39.0%) and the mean follow-up period was 5.5 ± 2.7 years. Multifocality was associated with high-risk features for recurrence, including extrathyroidal extension, lymph node metastasis, and margin involvement. After adjustment of those clinicopathological features, 10-year disease-free survival was 93.3% in patients with multifocal tumors, whereas those with unifocal disease showed 97.6% (p = 0.011). Multivariate Cox regression analysis indicated that male sex (HR 2.185, 95% CI 1.047–4.559), tumor size (HR 1.806, 95% CI 1.337–2.441), N1b LN metastasis (HR 3.603, 95% CI 1.207–10.757), and multifocality (HR 1.986, 95% CI 1.015–3.888) were independent predictors of recurrence. In conclusion, multifocality increased the risk of recurrence in patients with PTC. Patients with multifocal PTCs may need judicious treatment and follow-up approaches.
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spelling pubmed-85843842021-11-12 Impact of Multifocality on the Recurrence of Papillary Thyroid Carcinoma Woo, Joohyun Kim, Hyeonkyeong Kwon, Hyungju J Clin Med Article The incidence of thyroid cancer has dramatically increased over the last few decades, and up to 60% of patients have multifocal tumors. However, the prognostic impact of multifocality in patients with papillary thyroid carcinoma (PTC) remains unestablished and controversial. We evaluate whether multifocality can predict the recurrence of PTC. A total of 1249 patients who underwent total thyroidectomy for PTC at the Ewha Medical Center between March 2012 and December 2019 were reviewed. In this study, multifocality was found in 487 patients (39.0%) and the mean follow-up period was 5.5 ± 2.7 years. Multifocality was associated with high-risk features for recurrence, including extrathyroidal extension, lymph node metastasis, and margin involvement. After adjustment of those clinicopathological features, 10-year disease-free survival was 93.3% in patients with multifocal tumors, whereas those with unifocal disease showed 97.6% (p = 0.011). Multivariate Cox regression analysis indicated that male sex (HR 2.185, 95% CI 1.047–4.559), tumor size (HR 1.806, 95% CI 1.337–2.441), N1b LN metastasis (HR 3.603, 95% CI 1.207–10.757), and multifocality (HR 1.986, 95% CI 1.015–3.888) were independent predictors of recurrence. In conclusion, multifocality increased the risk of recurrence in patients with PTC. Patients with multifocal PTCs may need judicious treatment and follow-up approaches. MDPI 2021-11-02 /pmc/articles/PMC8584384/ /pubmed/34768664 http://dx.doi.org/10.3390/jcm10215144 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Woo, Joohyun
Kim, Hyeonkyeong
Kwon, Hyungju
Impact of Multifocality on the Recurrence of Papillary Thyroid Carcinoma
title Impact of Multifocality on the Recurrence of Papillary Thyroid Carcinoma
title_full Impact of Multifocality on the Recurrence of Papillary Thyroid Carcinoma
title_fullStr Impact of Multifocality on the Recurrence of Papillary Thyroid Carcinoma
title_full_unstemmed Impact of Multifocality on the Recurrence of Papillary Thyroid Carcinoma
title_short Impact of Multifocality on the Recurrence of Papillary Thyroid Carcinoma
title_sort impact of multifocality on the recurrence of papillary thyroid carcinoma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584384/
https://www.ncbi.nlm.nih.gov/pubmed/34768664
http://dx.doi.org/10.3390/jcm10215144
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