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Horm Metab Res 2023; 55(03): 161-168
DOI: 10.1055/a-2008-0824
Original Article: Endocrine Care

Papillary Thyroid Microcarcinoma: Insights from a Cohort of 257 Thyroidectomized Patients

Henrique Cabral Scherer 
1   Thyroid Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
,
Paula Martins Fernandes
1   Thyroid Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
,
Rafael Selbach Scheffel
1   Thyroid Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
2   Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
,
André Borsatto Zanella
1   Thyroid Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
3   Endocrinology, Hospital São Lucas da PUCRS, Porto Alegre, Brazil
,
Ana Luiza Maia
1   Thyroid Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
,
Jose Miguel Dora
1   Thyroid Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
› Author Affiliations Funding Information Fundo de Incentivo à Pesquisa e Eventos do Hospital de Clínicas de Porto Alegre. Programa Institucional de Bolsas de Iniciação Científica da Universidade Federal do Rio Grande do Sul. Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul.
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Abstract

Papillary thyroid microcarcinoma management evolved, and less aggressive strategies are now considered. Questions, however, remain on these tumors’ behavior, particularly on developing countries' real ground healthcare scenarios. Our aim is to gather insights on the natural history of papillary thyroid microcarcinoma on patients treated with thyroidectomy in Brazil. Consecutive patients diagnosed with papillary thyroid microcarcinoma had their clinical characteristics, interventions, and outcomes described. Patients were classified as incidental or nonincidental based on the diagnosis after or before surgery, respectively. A sum of 257 patients were included, 84.0% of which were women, and the mean age was of 48.3±13.5 years. The mean tumor size was of 0.68±0.26 cm, 30.4% were multifocal, 24.5% had cervical metastasis, and 0.4% distant metastasis. The nonincidental and incidental tumors differed in tumor size (0.72±0.24 and 0.60±0.28 cm, respectively, p=0.003) and in presence of cervical metastasis (31.3% and 11.9%, respectively, p<0.001). Male sex, nonincidental diagnosis, and younger age were independent predictors of cervical metastasis. After 5.5 years (P25–75 2.5–9.7) of follow-up, only 3.8% of patients had persistent structural disease (3.4% cervical). Predictors of persistent disease at multivariate analysis included cervical metastasis and multicentricity. In conclusion, incidental and nonincidental papillary thyroid microcarcinoma patients of the population studied displayed excellent outcomes. Cervical metastasis and multicentricity were frequent findings and prognostic factors for persistent disease.

Keywords

thyroid cancer - diagnosis - treatment

Supplementary Material



Publication History

Received: 14 October 2022

Accepted: 21 December 2022

Article published online:
16 February 2023

© 2023. Thieme. All rights reserved.

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