American Association of Endocrine SurgeonPapillary thyroid microcarcinoma: A study of 900 cases observed in a 60-year period
Section snippets
Patients and methods
Nine-hundred patients (627 female, 373 male) with a diagnosis of PTM underwent definitive primary surgical therapy at the Mayo Clinic in Rochester, Minn, during a 60-year period between January 1, 1945, and December 31, 2004. Patient age at initial treatment ranged from 6 to 89 years, with a mean of 46 years. These patients represented 31% of the 2,871 patients with PTC (of all tumor sizes) who had their initial surgical therapy at Mayo Clinic over this time period. During the first decade of
Mode of diagnosis
Over the 60 years of the study, initial pathologic diagnosis was made at the time of thyroid surgery in 427 cases (47%), while in 131 cases (15%) the diagnosis was made by an open biopsy of a cervical lymph node. In only 116 cases (13%) was the diagnosis of PTM considered to be an incidental finding at surgery. The introduction in the early 1980s of thyroid fine needle aspiration (FNA) biopsy altered the mode of initial diagnosis, so that between 1985 and 2004, PTM was diagnosed in 203/462
Discussion
We have reported the patterns and outcomes of treatment for a series of 900 patients with PTM over a period of 6 decades, largely confirming our previous report from a smaller subset of these patients.8 The current study, encompassing over 15,000 patient-years of follow-up, is the largest study of its type to date. The primary message of these data is that patients with PTM have an excellent prognosis. All cause mortality mirrors the anticipated mortality in a Midwestern population of similar
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2022, Surgery (United States)Citation Excerpt :The remaining 14 patients had incidental thyroid malignancies <1 cm and were considered papillary thyroid microcarcinomas. The implications of thyroid microcarcinomas without high-risk features, such as extrathyroidal extension and lymphovascular invasion, show that these small cancerous lesions do not increase the risk for disease recurrence.20,21 Therefore, patients can be counseled on the low-risk nature of these thyroid malignancies, with total thyroidectomy of an STG being curative without need for close follow-up or subsequent radioactive iodine treatment.
Thyroid Cancer A Review
2024, JAMA
Presented at the 29th Annual Meeting of the American Association of Endocrine Surgeons, Monterey, California, April 6–8, 2008.