RAEM REVISTA ARGENTINA DE
ENDOCRINOLOGÍA Y METABOLISMO
     
Volumen 52 #3 | Año 2015 Volver Indice
resumen Resumen abstract Abstract pdf PDF
 
  TRABAJO ORIGINAL
  Clinical, Hystopathologic Caractheristics and Prognostic Factors of Thyroid Microcarcinoma: A Retrospective Multicenter Study  
  Authors: Orlandi AM, Gauna A, Frascaroli G, Russo Picasso F, Castro Jozami L, Martínez MP  
     
  Introduction: Differentiated thyroid microcarcinoma (MCDT) has been defined as a differentiated thyroid cancer measuring 10 mm or less. The majority of these tumors are papillary thyroid carcinomas and comprise 30 % of all papillary thyroid carcinomas. Little is known of its natural history and there is an ongoing controversy in the field regarding its optimum management.
Objectives: 1) To describe the characteristics of MCDT 2) To assess risk factors for persistence and/ or recurrence of disease in a retrospective cohort of patients followed up at several health centers of the City of Buenos Aires (CABA).
Patients and Methods: The medical records of 187 patients with MCDT operated on between January 1st , 2000 and December 31st, 2009 at several centers of CABA were retrospectively reviewed, and clinical, histopathological, biochemical characteristics and risk factors were assessed.
Results: Most of the patients were female (82.8 %) and their mean age was 48 ± 13 (X ± SD) years. Median follow up was 38 months (range: 1 to 120 months), and 97 % of tumors were papillary thyroid cancers. Incidentalomas accounted for 29.4 % of tumors, mostly found during a surgical procedure undergone for the size of the goitre. Over 81 % of patients underwent a total thyroidectomy, while 91.4 % received radioactive iodine ablation. Patients with a follow-up longer than 12 months after surgery were analyzed longitudinally to assess prognostic factors of disease outcome (174 patients). After a mean follow-up of 49 ± 36.9 months, 146 (84 %) patients had no evidence of disease. Only postoperative, preablation Tg levels > 20 ng/ml were identified as an independent adverse prognostic factor in the multivariate analyses. In addition, age < 45 ys. (p< 0.01), tumor size > 0.5cm (p<0.017), and preablation Tg levels >20 ng/ml (p<0.011) were independent prognostic factors of a longer time to disease remission in the longitudinal analyses.
Conclusion: Differentiated thyroid microcarcinoma has an excellent prognosis in our local practice, with 84 % disease remission at long-term follow-up. Age at diagnosis, tumor size and preablation Tg levels were independent prognostic factors of time to disease remission.

Rev Argent Endocrinol Metab 52:129-136, 2015
No financial conflicts of interest exist.
 
     
  Key words: Differentiated thyroid microcarcinoma, clinical characteristics, prognostic factors, retrospective cohort, multicenter study  
 
 
 
 
 
 
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