Clinical Characteristics of Multifocal Papillary Thyroid Carcinoma

Abstract

Background and Objectives:Papillary thyroid cancers (PTCs) often present as multifocal tumors. Whether multifocal tumors are associated with increased risk of recurrence and mortality is still the subject of controversy. The aim of current study was to indi- vidualize factors associated with multifocality of papillary thyroid cancer and determine the clinical significance of multifocal thy- roid cancer. Subjects and Method:We undertook a retrospective study of 403 patients treated between January, 2003 and June, 2007 for papillary thyroid carcinoma by total thyroidectomy and central compartment neck dissection (n=403) with or without comprehensive lateral neck dissection. There were 342 women and 61 men whose mean age was 47.3 years old. Following criteria were used to study the pattern of and factors related with multifocality:sex, age, extracapsular extension, central compartment lymph node metastasis, the involvement of lateral neck lymph node, AMES risk group, distant metastasis. Results:Of those fac- tors, sex (p=0.0481), central compartment lymph node metastasis (p=0.0007), the involvement of lateral neck lymph node (p=0.0001) were significantly related factors for multifocality of papillary thyroid cancer. Age, primary tumor size, AMES risk group were not significantly related with multifocality. Bilateral or contralateral central compartment lymph node metastasis oc- curred more frequently in multifocal PTCs (64.0%) than solitary PTCs (46.9)(p=0.012). Conclusion:Our data suggest that the multifocal tumors in patients with papillary thyroid carcinoma are associated with increased risk of bilateral central compartment and lateral cervical lymph node metastasis. Therefore, total thyroidectomy and bilateral central compartment lymph node dissection should be recommended as a routine procedure in multifocal papillary carcinoma. (Korean J Otorhinolaryngol-Head Neck Surg 2009;52:512-5)