Characteristics of contralateral carcinomas in patients with differentiated thyroid cancer larger than 1 cm

被引：15

作者：

Lodewijk, Lutske ^{[1
]}

Kluijfhout, Wouter P. ^{[1
]}

Kist, Jakob W. ^{[1
]}

Stegeman, Inge ^{[1
]}

Plukker, John T. M. ^{[2
]}

van Dijkum, Els J. Nieveen ^{[3
]}

Bonjer, H. Jaap ^{[4
]}

Bouvy, Nicole D. ^{[5
]}

Schepers, Abbey ^{[6
]}

de Wilt, Johannes H. W. ^{[7
]}

Netea-Maier, Romana T. ^{[7
]}

van der Hage, Jos A. ^{[8
]}

Burger, Jacobus W. A. ^{[9
]}

Ho, Gavin ^{[10
]}

Lee, Wayne S. ^{[10
]}

Shen, Wen T. ^{[10
]}

Aronova, Anna ^{[11
]}

Zarnegar, Rasa ^{[11
]}

Benay, Cassandre ^{[12
]}

Mitmaker, Elliot J. ^{[12
]}

Sywak, Mark S. ^{[13
]}

Aniss, Ahmad M. ^{[13
]}

Kruijff, Schelto ^{[13
]}

James, Benjamin ^{[14
]}

Grogan, Raymon H. ^{[14
]}

Brunaud, Laurent ^{[15
]}

Hoch, Guillaume ^{[15
]}

Pandolfi, Chiara ^{[16
]}

Ruan, Daniel T. ^{[16
]}

Jones, Michael D. ^{[17
]}

Guerrero, Marlon A. ^{[17
]}

Valk, Gerlof D. ^{[1
]}

Rinkes, Inne H. M. Borel ^{[1
]}

Vriens, Menno R. ^{[1
,18
]}

机构：

[1] Univ Med Ctr Utrecht, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands

[2] Univ Groningen, Univ Med Ctr Groningen, Hanzepl 1, NL-9700 RB Groningen, Netherlands

[3] Acad Med Ctr Amsterdam, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands

[4] Vrije Univ Amsterdam Med Ctr, De Boelelaan 1117, NL-1081 HZ Amsterdam, Netherlands

[5] Maastricht Univ, Med Ctr, P Debyelaan 25, NL-6229 HX Maastricht, Netherlands

[6] Leiden Univ, Med Ctr, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands

[7] Radboud Univ Nijmegen, Med Ctr, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands

[8] Netherlands Canc Inst, Plesmanlaan 121-123, NL-1066 CX Amsterdam, Netherlands

[9] Erasmus MC, S Gravendijkwal 230, NL-3015 CE Rotterdam, Netherlands

[10] Univ Calif San Francisco, Med Ctr, 505 Parnassus Ave, San Francisco, CA 94143 USA

[11] Weill Cornell Med Ctr, 525 E 68th St, New York, NY 10065 USA

[12] McGill Univ, Ctr Hlth, 1650 Cedar Ave, Montreal, PQ H3G 1A4, Canada

[13] Univ Sydney, Endocrine Surg Unit, Camperdown, NSW 2006, Australia

[14] Univ Chicago, Med Ctr, 5841 S Maryland Ave, Chicago, IL 60637 USA

[15] Ctr Hosp Univ Nancy, 29 Ave Marechal Lattre de Tassigny, F-54000 Nancy, France

[16] Brigham & Womens Hosp, 75 Francis St, Boston, MA 02115 USA

[17] Univ Arizona, Med Ctr, 3838 N Campbell Ave, Tucson, AZ 85719 USA

[18] Univ Med Ctr Utrecht, Dept Surg G 04 228, POB 85500, NL-3508 GA Utrecht, Netherlands

来源：

LANGENBECKS ARCHIVES OF SURGERY | 2016年 / 401卷 / 03期

关键词：

Differentiated thyroid carcinoma; Contralateral carcinoma; Papillary microcarcinoma; Surgical strategy; QUALITY-OF-LIFE; COMPLETION THYROIDECTOMY; LOW-RISK; PAPILLARY; SURVIVORS; MICROCARCINOMA; SURGERY; MALIGNANCY; LOBECTOMY; PROFILES;

D O I：

10.1007/s00423-016-1393-4

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Purpose Traditionally, total thyroidectomy has been advocated for patients with tumors larger than 1 cm. However, according to the ATA and NCCN guidelines (2015, USA), patients with tumors up to 4 cm are now eligible for lobectomy. A rationale for adhering to total thyroidectomy might be the presence of contralateral carcinomas. The purpose of this study was to describe the characteristics of contralateral carcinomas in patients with differentiated thyroid cancer (DTC) larger than 1 cm. Methods A retrospective study was performed including patients from 17 centers in 5 countries. Adults diagnosed with DTC stage T1b-T3 N0-1a M0 who all underwent a total thyroidectomy were included. The primary endpoint was the presence of a contralateral carcinoma. Results A total of 1313 patients were included, of whom 426 (32 %) had a contralateral carcinoma. The contralateral carcinomas consisted of 288 (67 %) papillary thyroid carcinomas (PTC), 124 (30 %) follicular variant of a papillary thyroid carcinoma (FvPTC), 5 (1 %) follicular thyroid carcinomas (FTC), and 3 (1 %) Hurthle cell carcinomas (HTC). Ipsilateral multifocality was strongly associated with the presence of contralateral carcinomas (OR 2.62). Of all contralateral carcinomas, 82 % were <= 10 mm and of those 99 % were PTC or FvPTC. Even if the primary tumor was a FTC or HTC, the contralateral carcinoma was (Fv) PTC in 92 % of cases. Conclusions This international multicenter study performed on patients with DTC larger than 1 cm shows that contralateral carcinomas occur in one third of patients and, independently of primary tumor subtype, predominantly consist of microPTC.

引用

页码：365 / 373

页数：9

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