Abstract
BackgroundPapillary thyroid carcinoma (PTC) is one of the most frequent endocrine malignancies. In most cases, it often presents as multifocal tumor. It has been reported that multifocal tumors are associated with elevated risk of lymph node and distant metastases. Multifocality is also one of the factors predicting prognosis. Recent studies show that BRAFV600E mutation occurs more frequently in aggressive PTC. The purpose of this study was to evaluate BRAFV600E status and clinicopathological features in multiple and solitary PTC.MethodsWe performed a retrospective study to analyze 512 PTC cases who received surgery, including 376 solitary PTCs and 136 multiple PTCs.ResultsMultiple PTC is more related to lymph node metastasis and vascular invasion than solitary PTC. However, the distant metastasis rate and 10-year survival rate showed no difference between these two groups. BRAFV600E mutation status was more frequent in multiple PTC patients with lymph node metastasis and late stage at diagnosis.ConclusionBRAFV600E mutation is most commonly associated with extra-thyroidal extension and lymph node metastasis in PTC. Multiple PTC patients with young age, large tumors and BRAFV600E mutation should be followed carefully. Our study provides useful information for PTC patients’ followup and treatment.
Highlights
Papillary thyroid carcinoma (PTC) is one of the most frequent endocrine malignancies
Comparison of progression between patients with solitary and multiple PTC Papillary thyroid carcinomas represent about 90% of all thyroid cancers and tumor incidence has been increasing in recent decades [2,10]
We performed a retrospective study of 376 patients with solitary PTC and 136 patients with multiple PTC to assess the risk factors in disease progression at diagnosis, including sex, age at diagnosis, extra-thyroidal extension, vascular invasion, lymph node metastasis, distant metastasis Hashimoto’s thyroiditis, and 10-year survival rate, etc (Table 2)
Summary
Papillary thyroid carcinoma (PTC) is one of the most frequent endocrine malignancies. In most cases, it often presents as multifocal tumor. Some clinical factors have been used to predict which patients with thyroid cancer might have worse prognosis. Factors such as older age (>45 years old), male gender, certain histologic subtypes (i.e. tall cell, columnar cell and diffuse sclerosing variants of PTC), tumor size greater than 4 cm and presence of extrathyroidal extension are associated with neck recurrences and distant metastases [15,16,17,18]. Intraglandular dissemination from the dominant tumor may serve as an indicator of metastatic potential and more aggressive phenotype
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