Tumor aggressiveness risk factors in the differentiated thyroid carcinoma.

Abstract

The differentiated thyroid carcinoma (DTC) is the most frequent malignancy in endocrinology (95%). Our aim was to retrospectively compare risk factors of tumor aggressiveness and history of thyroid disease in patients with conventional DTC and differentiated thyroid microcarcinoma (DTMC). Retrospective analysis of 167 patients after total thyroidectomy with a histologically confirmed DTC, of which 83 patients with conventional DTC (> 1 cm) and 84 with DTMC (≤ 1 cm). The analyzed factors were tumor size, its aggressiveness (i.e. multifocal or bilateral occurrence, angioinvasion, extracapsular growth, presence of cervical lymph node metastases, distant metastases, and early local relapse) and medical history of thyroid diseases. In the DTMC group, there were 80/84 (95.2%) papillary carcinomas compared with 58/83 (69.9%) in the conventional DTC group (p=0.001). Patients with DTMC were significantly older than those with conventional DTC (p=0.006). In the conventional DTC group, there was a significantly higher occurrence of angioinvasion and extracapsular growth (p=0.001), cervical lymph node metastases (p=0.013), relapse (p=0.018), and distant metastases (p=0.007), compared with the DTMC group. In patients with DTMC, there was a significantly lower presence of risk factors of tumor aggressiveness, compared with the conventional DTC group (Tab. 2, Ref. 17).