Microscopic extrathyroidal extension unrelated to outcomes in papillary thyroid carcinoma

Outcomes, persistence of disease and mortality are unlikely to be affected by microscopic extrathyroidal extension in patients with papillary thyroid carcinoma, according to study findings presented at the European Congress of Endocrinology.

“Thus, a conservative management strategy for patients with [microscopic extrathyroidal extension] may avoid potential adverse effects of more aggressive treatments without worsening their prognosis,” Bernardo Marques, MD, of the endocrinology department at the Instituto Português de Oncologia de Coimbra in Portugal, told Endocrine Today.

Marques and colleagues evaluated data from an institutional database on 603 consecutive patients who underwent surgery for papillary thyroid carcinoma between 2000 and 2012 to determine the effect of microscopic extrathyroidal extension on outcome in patients with papillary thyroid carcinoma with tumors smaller than 4 cm. No participants had clinically apparent lymph node or distant metastasis at diagnosis; all had a nonaggressive histologic variant. Participants were followed for a minimum of 3 years after surgery.

Bernardo Marques

Based on findings from microscopic extrathyroidal extension, 15.6% of patients had their diagnosis upstaged.

Participants whose diagnosis was upstaged were older, had larger tumors, and were more likely to receive radioiodine ablation therapy (P < .001) and undergo prophylactic lymph node resection (P = .017) compared with those whose diagnosis was not upstaged.

Extension of thyroid surgery, recurrence rate or persistence of disease at the end of the follow-up were not significantly linked to microscopic extrathyroidal extension.

“The extent of surgical resection or the use of [radioactive iodine] might not have an impact on survival or recurrence, and therefore, in selected patients, complete thyroidectomy after lobectomy or the use of postoperative [radioactive iodine] may not be required when a pathological function of [microscopic extrathyroidal extension] is found,” Marques told Endocrine Today. – by Amber Cox

Reference:

Marques B, et al. Abstract OC14.4. Presented at: European Congress of Endocrinology; May 28-31, 2016; Munich.

For more information:

Bernardo Marques, MD, can be reached at Endocrinology Department, Instituto Português de Oncologia de Coimbra FG, EPE, Avenida Bissaya Barreto 98, 3000-075 Coimbra, Portugal; email: ber.marques89@gmail.com.

Disclosure: Marques reports no relevant financial disclosures.