Prognostic parameters for recurrence of papillary thyroid microcarcinoma

Clinicopathological parameters predicting PTMC recurrence were determined by retrospective analysis of 307 patients.Of the 293 patients eligible for analysis, 14 (5%) had recurrence during a median follow-up time of 65 months. Recurrence was observed in 8 of 166 patients (0.5%) treated with total or near-total thyroidectomy; gender (P = 0.02) and presence of lateral cervical node metastases at initial surgery (P = 0.01) were associated with recurrence. Six of the 127 patients (0.5%) treated with hemi- or subtotal thyroidectomy experience recurrences, but no significant prognostic factor for recurrence was identified. Multivariate Cox-regression analysis showed that gender and cervical lymph node metastasis were significant variablesPTMC showed very diverse disease extent and could not be regarded as indolent, relatively benign disease based on the primary tumor size. The extent of surgery should be based on prognostic parameters, such as gender and lateral neck node metastasis, in patients with PTMC.Papillary thyroid microcarcinoma (PTMC) is defined as a papillary thyroid carcinoma equal to or less than 1 cm in size, including extrathyroid extensions and/or nodal metastases. Recent reports have suggested that the increasing incidence of thyroid cancer is predominantly because of the increased detection of small papillary cancers[1,2]. Most PTMCs are incidentally detected by histological analysis of thyroid glands removed for preoperatively diagnosed benign diseases, or are indirectly diagnosed because of the presence of enlarged metastatic cervical lymph nodes or distant metastases [3,4]. In Korea and Japan, however, where ultrasonography is frequently used in the initial examination of thyroid glands [5-7], the incidence of PTMC has increased explosively [8].Although PTMC used to be considered a rather benign entity with a very long indolent course, recent findings indicate that PTMCs are frequently detected in patients displaying factors associated with poor progn