Publication:
Tumor border pattern and size help predict lymph node status in papillary microcarcinoma: a clinicopathologic study

dc.contributor.coauthorPeker, Önder
dc.contributor.coauthorTerzioğlu, Tarık
dc.contributor.departmentKUH (Koç University Hospital)
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorAğcaoğlu, Orhan
dc.contributor.kuauthorArmutlu, Ayşe
dc.contributor.kuauthorDemirkol, Mehmet Onur
dc.contributor.kuauthorKapran, Yersu
dc.contributor.kuauthorTaşkın, Orhun Çığ
dc.contributor.kuauthorTezelman, Tevfik Serdar
dc.contributor.schoolcollegeinstituteKUH (KOÇ UNIVERSITY HOSPITAL)
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2024-11-09T23:00:03Z
dc.date.issued2020
dc.description.abstractObjective: Lymph node metastasis occurs in a subset of papillary microcarcinoma patients. We aimed to analyze the differences between metastatic and non-metastatic papillary microcarcinomas in order to identify a high-risk subgroup that is likely to require more aggressive treatment. Materials and methods: 126 thyroidectomies with lymph node dissections (central +/- lateral), diagnosed as papillary microcarcinoma, were reviewed. Results: Mean age of 126 patients (F/M = 3.3) was 42 years. Mean size of the largest tumor was 7 mm. Classical was the most frequently (89%) encountered subtype. Multiple histologic subtypes co-occurred in 19%. Lymphovascular invasion was present in 16% (n = 20). 55 (44%) and 71 (56%) cases were unifocal and multifocal, respectively. 90 cases (71%) were non-encapsulated with overall infiltrative tumor borders, whereas in 36 cases (29%), the tumor had a well-defined capsule. Among those, 23 (64%) had tumor capsule invasion. 47 (37%) cases had metastasis in lymph nodes. In univariate analysis, metastasis was associated with tumor size of > 5 mm (p = 0.02), tumor burden of > 5 mm (p = 0.03), lymphovascular invasion (p = 0.02) and non-encapsulation (p = 0.01). No associations were found regarding sex, age, histologic subtype, lymphocytic thyroiditis, tumor capsule invasion (in capsulated tumors), laterality and multifocality (p > 0.05). In multivariate analysis, lymphovascular invasion (p = 0.01, OR = 3.97, 95% CI 1.35-11.67), tumor size > 0.5 cm (p = 0.031, OR = 2.92, 95% CI 1.10-7.71) and non-encapsulation (p = 0.033, OR = 2.85, 95% CI 1.08-7.51) were independent risk factors. Conclusion: Size (largest tumor or sum of all foci) of > 5 mm, non-encapsulation and lymphovascular invasion were independent predictors of LNM in PMs. Unifocal tumors metastasize the same as multifocal tumors, suggestive of the contribution of other factors. Patients with sporadically resected microcarcinomas should be carefully followed-up, especially those that harbor risk factors in histology.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.openaccessNO
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.volume48
dc.identifier.doi10.1016/j.anndiagpath.2020.151592
dc.identifier.eissn1532-8198
dc.identifier.issn1092-9134
dc.identifier.quartileQ3
dc.identifier.scopus2-s2.0-85089918209
dc.identifier.urihttps://doi.org/10.1016/j.anndiagpath.2020.151592
dc.identifier.urihttps://hdl.handle.net/20.500.14288/7984
dc.identifier.wos576852000013
dc.keywordsThyroid
dc.keywordsMicrocarcinoma
dc.keywordsLymph node metastasis
dc.keywordsSize
dc.keywordsEncapsulation
dc.keywordsLymphovascular invasion
dc.keywordsThyroid microcarcinoma
dc.keywordsUnited-States
dc.keywordsRisk-factors
dc.keywordsMetastasis
dc.keywordsRecurrence
dc.keywordsCarcinoma
dc.keywordsFeatures
dc.keywordsControversies
dc.keywordsDissection
dc.keywordsInvasion
dc.language.isoeng
dc.publisherElsevier
dc.relation.ispartofAnnals of Diagnostic Pathology
dc.subjectPathology
dc.titleTumor border pattern and size help predict lymph node status in papillary microcarcinoma: a clinicopathologic study
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorTaşkın, Orhun Çığ
local.contributor.kuauthorArmutlu, Ayşe
local.contributor.kuauthorAğcaoğlu, Orhan
local.contributor.kuauthorDemirkol, Mehmet Onur
local.contributor.kuauthorTezelman, Tevfik Serdar
local.contributor.kuauthorKapran, Yersu
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit1KUH (KOÇ UNIVERSITY HOSPITAL)
local.publication.orgunit2KUH (Koç University Hospital)
local.publication.orgunit2School of Medicine
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relation.isOrgUnitOfPublicationd02929e1-2a70-44f0-ae17-7819f587bedd
relation.isOrgUnitOfPublication.latestForDiscoveryf91d21f0-6b13-46ce-939a-db68e4c8d2ab
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