Does the T1 subdivision correlate with the risk of recurrence of papillary thyroid cancer?
| العنوان: | Does the T1 subdivision correlate with the risk of recurrence of papillary thyroid cancer? |
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| المؤلفون: | Nathalie Chereau, Fabrice Menegaux, Frédérique Tissier, Laurence Leenhardt, Gaelle Godiris-Petit, Séverine Noullet, Christophe Trésallet |
| المساهمون: | Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d’Endocrinologie, Métabolisme et Prévention des Risques Cardio-Vasculaires [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de pathologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Service de médecine nucléaire [CHU Pitié-Salpétrière], Service de Chirurgie Générale, Viscérale et Endocrinienne [CHU Pitié-Sapêtrière] |
| المصدر: | Langenbeck's Archives of Surgery Langenbeck's Archives of Surgery, 2016, 401 (2), pp.223-230. ⟨10.1007/s00423-016-1399-y⟩ Langenbeck's Archives of Surgery, Springer Verlag, 2016, 401 (2), pp.223-230. ⟨10.1007/s00423-016-1399-y⟩ |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Oncology, Male, medicine.medical_treatment, Papillary, Gastroenterology, Papillary thyroid cancer, 0302 clinical medicine, Recurrence, Thyroid cancer, Lymph node, Aged, 80 and over, Middle Aged, 3. Good health, Dissection, medicine.anatomical_structure, Cardiothoracic surgery, Thyroid Cancer, Papillary, 030220 oncology & carcinogenesis, Thyroidectomy, Female, Adult, Risk, medicine.medical_specialty, Adolescent, 030209 endocrinology & metabolism, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Lymph node dissection, Disease-Free Survival, 03 medical and health sciences, Young Adult, Internal medicine, medicine, Humans, Thyroid Neoplasms, Aged, Neoplasm Staging, Retrospective Studies, business.industry, Carcinoma, Retrospective cohort study, medicine.disease, Carcinoma, Papillary, Lymph Node Excision, Surgery, Neoplasm Recurrence, Local, business, Lymph node metastases, Abdominal surgery |
| الوصف: | International audience; BackgroundBased on the AJCC seventh TNM classification, T1 intraglandular tumors are subdivided into T1a (≤10 mm) and T1b (11–20 mm), but the differences in prognosis remain controversial. The present study aimed to determine the clinicopathological features and outcomes of T1a and T1b patients.MethodsA retrospective study of 2518 T1 patients, including 1840 T1a (73 %) and 678 (27 %) T1b patients who underwent surgery for PTC from 1978 to 2014, was conducted. In patients with a preoperative or operative diagnosis of PTC, a total thyroidectomy (TT) with prophylactic (macroscopically N0) or therapeutic (evident N1) lymph node dissection (LND) was performed. Other patients had a TT or partial thyroidectomy without LND. The mean follow-up time was 8.9 ± 8.8 years (median, 6.5 years; range, 1–36.4 years).ResultsA TT was performed in 2273 patients (90 %), including 1184 (52 %) with LND. Other patients (n = 245) had a single lobectomy with isthmectomy. Multifocality, bilaterality, number of tumors, sum of the largest size of all foci, vascular invasion, and (in patients with LND) LN metastases were significantly more frequent in T1b than in T1a patients. Of the 1184 patients with LND, 278 had LN metastases (N1, 23 %), including 136/680 T1a (20 %) and 142/504 (28 %) T1b patients (p = 0.002). These LN metastases were diagnosed after a prophylactic LND in 86/609 T1a (14 %) and 93/440 T1b (21 %) patients (p = 0.001). Recurrences were more frequent in T1b (n = 26, 3.8 %) than in T1a patients (n = 35, 1.9 %, p = 0.005). In the multivariate analysis, independent prognostic factors for recurrence in both groups were the number of tumors, the sum of the largest size of all foci and, in patients who had LND, LN metastases and extranodal extension. For N0-x patients, the recurrence rate was significantly higher in the T1b than in the T1a group (2.4 vs. 0.9 %, respectively, p = 0.005), although this rate was similar in N1 patients (16.2 % for T1a and 9.2 % for T1b patients, p = 0.1). The 5-year disease-free survival rates for T1a and T1b patients were 98.3 and 96.6 %, respectively (p = 0.01).ConclusionFor PTC patients, T1b had poorer clinicopathological features and increased risk of recurrence than T1a. |
| تدمد: | 1435-2451 1435-2443 |
| DOI: | 10.1007/s00423-016-1399-y⟩ |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9193d6f1d3cadb69f99dfd0367784bb8 https://pubmed.ncbi.nlm.nih.gov/26957089 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....9193d6f1d3cadb69f99dfd0367784bb8 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14352451 14352443 |
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| DOI: | 10.1007/s00423-016-1399-y⟩ |