Symptomatic papillary thyroid carcinoma tied to frequent recurrence, lower overall survival

Asymptomatic papillary thyroid carcinoma results in lower recurrence and higher overall survival rates compared with symptomatic disease.

Patients with symptomatic papillary thyroid carcinoma (PTC) may be more likely to require total thyroidectomy and close posttreatment surveillance, according to researchers.

Jong-Lyel Roh, MD, PhD, of the department of otolaryngology at Asan Medical Center, University of Ulsan College of Medicine in Korea, and colleagues evaluated data from 1,419 adults (1,145 women; median age, 55 years) who underwent thyroidectomy for differentiated PTC between 2006 and 2009 at Asan Medical Center to compare recurrence and survival outcomes among patients with symptomatic and asymptomatic PTC. Follow-up was conducted for a median of 95 months.

Ultrasonography, CT, MRI and 18F-fluorodeoxyglucose PET/CT were used to detect asymptomatic PTC. Overall, 88.7% of participants had asymptomatic PTC, according to the researchers.

Compared with the asymptomatic group, the symptomatic group had more readily palpable thyroid nodules (P < .001), larger thyroid nodules (P < .001), larger extrathyroidal extension (P < .01), higher tumor and node stages (P < .01) and more frequent extranodal extension (P = .011).

Overall, 58 participants experienced a cancer recurrence with the frequency greater in the symptomatic group compared with the asymptomatic group (P < .001), according to the researchers. Compared with the asymptomatic group, the symptomatic group had higher cause-specific and noncancer death rates (P < .001). The 5-year survival rates were higher in participants with asymptomatic PTC for recurrence-free survival (P < .001) and overall survival (P < .001) compared with participants with symptomatic PTC. – by Amber Cox

Disclosure: The researchers report no relevant financial disclosures.

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Source: Kim SH, et al. Thyroid. 2016;doi:10.1089/thy.2016.0238.