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Prognostic significance of the sum of the diameters of single foci in multifocal papillary thyroid cancer: the concept of new-old tumor burden
- Source :
- Therapeutic Advances in Endocrinology and Metabolism, Therapeutic Advances in Endocrinology and Metabolism, Vol 11 (2020)
- Publication Year :
- 2020
- Publisher :
- SAGE Publications, 2020.
-
Abstract
- Aim: The prognostic value of multifocality (Mu) in papillary thyroid cancer (PTC) remains controversial. The present study aimed to investigate this issue and test the possible prognostic significance of the sum of the diameters of single foci (SDSF), the total number of foci (TNF), and primary tumor size (PTS) in multifocal PTC. Methods: We retrospectively analyzed a single-center consecutive series of 370 PTCs. For multifocal cases we analyzed bilaterality occurrence, SDSF, TNF, and PTS. Results: Mu was observed in 41.1% PTCs, and bilaterality in 30%. Mu was associated with an advanced T-category. In bilateral multifocal PTC, the PTS was larger, and microPTC was less frequent, while T-categories were higher. Mu and bilaterality per se had no impact on prognosis. At univariate analysis, PTS, SDSF, vascular invasion, lymph node metastases, distant metastases, T-categories, Initial Risk Stratification System score, second treatment and TERT promoter mutation correlated with persistence/recurrence or death in the multifocal PTC group. On multivariate Cox proportional hazards regression analyses, SDSF again independently predicted persistence/recurrence or death in multifocal PTCs. We found that a cut-off for SDSF less than 40 mm was able to identify multifocal PTC patients with a very low risk of persistence/recurrence (negative predictive value 96.9%). Disease-free survival was significantly shorter in patients with multifocal PTCs and SDSF ⩾40 mm. Conclusions: Mu and bilaterality per se were not prognostically significant. SDSF emerged as a new independent prognostic factor for persistence/recurrence of multifocal PTC. SDSF might better represent the tumor burden in multifocal PTC, with SDSF
- Subjects :
- Oncology
medicine.medical_specialty
lcsh:RC648-665
endocrine system diseases
business.industry
Endocrinology, Diabetes and Metabolism
Tumor burden
030209 endocrinology & metabolism
multifocality
medicine.disease
lcsh:Diseases of the endocrine glands. Clinical endocrinology
Papillary thyroid cancer
sum of diameters of single foci
03 medical and health sciences
0302 clinical medicine
030220 oncology & carcinogenesis
Internal medicine
medicine
papillary thyroid cancer
business
Value (mathematics)
bilaterality
tumor burden
Original Research
Subjects
Details
- Language :
- English
- ISSN :
- 20420196 and 20420188
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Therapeutic Advances in Endocrinology and Metabolism
- Accession number :
- edsair.doi.dedup.....b6ba8a2f27b5a4d995047a76f6a4294f