Clinical, Surgical and Histopathologic Outcomes of Filipino Patients with Micropapillary Thyroid Carcinoma in a Tertiary University Hospital in the Philippines
Objective. Micropapillary thyroid carcinoma (micro-PTC) has a good prognosis but a number of cases will present with aggressive behavior. This study aims to determine the clinical outcomes with surgical management and histopathologic characteristics of Filipino patients with micro-PTC at University of Santo Tomas Hospital.
Methodology. 139 patients were diagnosed with micro-PTC from the year 2004-2011. Seventy five patients had complete data and were included in this retrospective study. Chi square test with Yates correction, T-test for tumor diameter, statistical means and percentages were used in data analysis.
Results. A total of 1,689 thyroid surgeries were done between 2004 and 2011. There were 1,054 patients (62.4%) diagnosed with benign thyroid tumor(s) and 635 patients (37.6%) with well-differentiated thyroid carcinoma. Of these, 139 (22%) patients have micro-PTC. The prevalence rate of micro-PTC was 22%, with a female predominance (86.6%). The patients’ ages ranged from 24-80 years old with a mean age of 47 years. Comparison of groups showed that having either incidental or non-incidental micro-PTC is independent of the clinical variables of the patient. Two (2.6%) patients initially presented with cranial and supraclavicular metastasis. This study had a low recurrence rate (5.3%) and a mortality rate of 1.3%.
Conclusion. Male gender is the only significant variable for lymph node and distant metastasis. The patient’s age, family history of cancer, number of foci, size and histological type of tumor have no prognostic value.
Hedinger C, Williams ED, Sobin LH. The WHO histological classification of thyroid tumours: A commentary on the second edition. Cancer.1989;63:908–11.
Elisei R, Molinaro E, Agate L. Single-Institution 35-Year Study on 4187 Patients. J Clin Endocrinol Metab. 2010; 95(4):1516–1527.
Fish SA, Langer JE, Mandel SJ. Sonographic imaging of thyroid nodules and cervical lymph nodes. Endocrinol Metab Clin N Am. 2008; 37:401–417.
Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009; 19:1167–1214.
Lundgren CI, Hall P, Dickman PW, Zedenius J. Influence of surgical and postoperative treatment on survival in differentiated thyroid cancer. Br J Surg. 2007; 94(5):571-577.
Frates MC, Benson CB. Society of radiologists in ultrasound management of thyroid nodules detected at US: Society of radiologists in ultrasound consensus conference statement. Radiology. 2005; 237:794–800.
Baskin HJ, Duick DS. The endocrinologists’ view of ultrasound guidelines for fine needle aspiration. Thyroid. 2006; 16:207–208.
Mazzaferri EL, Kloos RT. Clinical review 128: Current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab. 2001; 86:1447–1463.
Murray D. The thyroid gland, Functional endocrine pathology, 2nd ed. Malden: Blackwell Science, 1998.
Shah JP, Patel SG. Thyroid and parathyroid glands. In: Head and neck surgery and oncology, 3rd ed. Philadelphia: Mosby, 2003.
Kus HK, Shah M, Eski S, Walfish PG, Freeman JL. Thyroid cancer outcomes in Filipino patients. Arch Otolaryngol Head and Neck Surg. 2010; 136 (2): 138-142.
Pelizzo MR, Boschin IM, Toniato. Papillary thyroid microcarcinoma (PTMC): Prognostic factors, management and outcome in 403 patients. Eur J Surg Oncol. 2006;32:1144–8.
Ross DS, Litofsky D, Ain KB, et al. Recurrence after treatment of micropapillary thyroid cancer. Thyroid. 2009; 19(10):1043-8.
Silva GA, Aragon JB. Clinical outcomes of papillary thyroid microcarcinoma in Filipino patients: A 12-year experience at Makati Medical Center. Phil J Internal Medicine. Nov-Dec 2009; 47: 237-244.
Pearce EN, Braverman LE. Editorial: Papillary thyroid microcarcinoma outcomes and implications for treatment. J Clin Endocrinol Metab. 2004; 89(8):3710-3712.
Bernet, V. Approach to the Patient with incidental papillary microcarcinoma, J Clin Endocrinol Metab. August 2010; 95(8): 3586-3592.
Ito, Y. Therapeutic strategy for papillary microcarcinoma of the thyroid. Curr Cancer Ther Rev. 2005; 1:19-25.
Ito Y, Miyauchi A, Inoue H, et al. An observational trial for papillary thyroid microcarcinoma in Japanese patients. World J Surg. January 2010; 34(1): 28-35.
Roti, E. Clinical and histological characteristics of papillary thyroid microcarcinoma: Results of the retrospective study in 243 patients. J Clin Endocrinol Metab. June 2006; 91(6): 2171-2178.
Roti E, degli Uberti EC, Bondanelli M, Braverman LE. Thyroid papillary microcarcinoma: A descriptive and meta-analysis study. Eur J Endocrinol.2008;159(6):659–673.
Baudin, E, Travagli JP, Ropers, J, et al. Microcarcinoma of the thyroid gland: The Gustave Roussy Institute experience. Cancer. 1998;83:553–559.
Pellegriti, G. Clinical behavior and outcome of papillary thyroid cancers smaller than 1.5cm in diameter: Study of 299 Cases. J Clin Endocrinol Metab. August 2004; 89(8):3713-3720.
Chow SM, Law SCK, Chan JKC, Au SK, Yau S, Lau WH. Papillary microcarcinoma of the thyroid-prognostic significance of lymph node metastasis and multifocality. Cancer. 2003; 98:31-40.
How to Cite
Journal of the ASEAN Federation of Endocrine Societies is licensed under a Creative Commons Attribution-NonCommercial 4.0 International. (full license at this link: http://creativecommons.org/licenses/by-nc/3.0/legalcode).
To obtain permission to translate/reproduce or download articles or use images FOR COMMERCIAL REUSE/BUSINESS PURPOSES from the Journal of the ASEAN Federation of Endocrine Societies, kindly fill in the Permission Request for Use of Copyrighted Material and return as PDF file to email@example.com or firstname.lastname@example.org.
A written agreement shall be emailed to the requester should permission be granted.