Factors Associated with Adverse Outcome in Papillary Microcarcinoma of Thyroid EC10-EC13
Dr. Sheima R Das,
Associate Professor, Department of Pathology, Government Medical College, Kollam, Kerala, India.
Introduction: Papillary microcarcinoma thyroid are increasingly diagnosed recently, and are found to have an indolent course and excellent prognosis. Distant metastasis and tumour related mortality are very less. However, there is a subset of microcarcinomas which are aggressive and require therapeutic management similar to larger tumours. The prognostic factor in this aggressive subtype is not well-defined. This study attempts to identify the factors associated with lymph node metastasis and recurrence, and hence, the risk stratification of patients.
Aim: To determine the clinical and histomorphological factors that are associated with adverse outcome in patients with papillary microcarcinoma of thyroid.
Materials and Methods: This was a cohort study done from 2008 to 2015 in the Department of Pathology. Study subjects included retrospective cases from 2008 to 2013 and prospective subjects from 2013 to 2015. The clinical details and histopathological features were assessed and were compared in patients with and without adverse outcome.
Results: A total of 55 patients were included in the study. Majority of the patients belonged to the age group of 41-50 years and were females. Only five patients had lymph node metastasis at the time of presentation. None had recurrence during the follow-up period. Male gender, multifocality, capsular invasion and moderate tumour fibrosis were found to be significantly more associated with adverse outcome.
Conclusion: This study focuses on the importance of assessing histopathological features in determining the high risk groups in papillary microcarcinoma. The high risk groups require radioablation and more rigorous follow-ups.