Retrospective comparison of screening criteria for active surveillance for papillary thyroid microcarcinoma

Kai Qian; Tuanqi Sun; Kai Guo; Xiaoke Zheng; Duanshu LI; Wenjun Wei; Yi WU; Qinghai JI; Zhuoying Wang

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Retrospective comparison of screening criteria for active surveillance for papillary thyroid microcarcinoma

VernacularTitle: 甲状腺微小乳头状癌密切随访标准的回顾性比较研究
Author: Kai QIAN ^{1
,

2} ; Tuanqi SUN ^{1
,

2} ; Kai GUO ^{1
,

2} ; Xiaoke ZHENG ^{1
,

2} ; Duanshu LI ^{1
,

2} ; Wenjun WEI ^{1
,

2} ; Yi WU ^{1
,

2} ; Qinghai JI ^{1
,

2} ; Zhuoying WANG ^{1
,

2}
Author Information

1. Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center
2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
Publication Type:Journal Article
Keywords: Thyroid neoplasms; Carcinoma, papillary; Follow-up studies; Pathology, clinical; Recurrence; Disease-free survival
From: Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2017;52(6):430-434
CountryChina
Language:Chinese
Abstract: Objective:To investigate the rationality of management of active surveillance for papillary thyroid microcarcinoma (PTMC) and the main indications for active surveillance for PTMC.
Methods:In this study, two criteria were used to evaluate patients with PTMC: low-risk PTMC conditions defined by Kuma hospital and Chinese Association of Thyroid Oncology (CATO) consensus on PTMC management of active surveillance. The patients had received surgical treatment. Clinicopathological characteristics and prognosis of the patients in different groups were compared.
Results:A total of 778 patients were enrolled in the study, 565 (72.6%) of them met Kuma screening criteria and only 112 (14.4%) met CATO screening criteria. Kuma low-risk subgroup had lower incidence of cervical lymph node metastasis than Kuma high-risk PTMC subgroup(30.6% vs 47.9%, P<0.05). There were significant differences in multifocal lesions(6.3% vs 16.4%), extrathyroidal extension (1.8% vs 7.5%) and cervical lymph node metastasis(19.6% vs 38.0%) between low-risk and high-risk CATO PTMC subgroups. Patients in the CATO low-risk PTMC subgroup had lower recurrence and longer disease-free survival (DFS) than those in the CATO high-risk PTMC subgroup. But there was no significant difference in recurrence or DFS between Kuma low-risk and high-risk Kuma PTMC subgroups.The Chi-square test of Fisher′s exact probabilities test was used to compare clinicopathological characteristics of patients between different groups.Rates of disease-free survival were calculated using the Kaplan-Meier method.
Conclusion:CATO screening criteria is relatively strict and may be more suitable for Chinese patients with active surveillance for PTMC.