Treatment and prognostic factors of papillary thyroid microcarcinoma

Objective: To discuss the prognostic factors and outcomes of treatment in patients diagnosed with papillary thyroid microcarcinoma. Design: Retrospective observational case review. Setting: Department of Otorhinolaryngology of the tertiary referral teaching hospital of Parma. Participants: Ninety-seven patients diagnosed with PTMC and surgically treated between January 1998 and December 2007. Main outcome measures: Clinical and histopathological characteristics of the study group were identified and statistically analysed. Results: No cancer-related deaths were registered. Incidence of recurrent disease was 9% after a 43 month mean follow-up (range 12-120). Univariate analysis detected that metastases in neck lymph nodes at diagnosis (p = 0.025), a tumour > 5 mm in size (p = 0.011), the presence of bilateral tumoural foci (p = 0.007), the presence of capsular invasion (p = 0.001), and the presence of vascular invasion (p = 0.004) were related to recurrent disease. On multivariate analysis, the presence of bilateral tumoural foci (p = 0.030), and the presence of capsular invasion (p = 0.005) were significantly related to tumour recurrence. Conclusion: The prognosis for patients with papillary thyroid microcarcinoma in this series was excellent, with a 100% survival rate and minimal surgical-related morbidity. Nevertheless, approximately 10% of patients developed recurrent disease; aggressive treatment may be justified depending on the presence or absence of prognostic risk factors.