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KMID : 1202020100030020155
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Journal of Korean Thyroid Association
2010 Volume.3 No. 2 p.155 ~ p.159
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Predictive Factors of Coexistent Contralateral Occult Carcinoma in Unilateral Papillary Thyroid Carcinoma
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Kim Hyo-Jin
Seo Sung-Tae
Yoon Yeo-Hoon
Koo Bon-Seok
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Abstract
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Background and Objectives : Decision of surgical boundaries of thyroidectomy for unilateral papillary thyroid cancer (PTC) is open to argument. The purpose of this study is to evaluate the various clinical and pathological factors associated with occult carcinoma in contralateral lobe in patients with unilateral PTC.
Materials and Methods : From march 2005 to april 2010, 270 consecutive cases who underwent total thyroidectomy with central neck dissection for clinically unilateral PTC were retrospectively reviewed. The frequency, pattern and predictive factors for occult contralateral carcinoma in these patients were analyzed with respect to the following variables: age, sex, tumor size, multicentricity of primary tumor, presence of perithyroidal invasion, lymphovascular invasion or capsular invasion and presence of central lymph node metastasis.
Results:Thirty six (13.3%) patients had occult carcinoma in the contralateral lobe. The multicentricity of primary tumor in ipsilateral lobe (p=0.001) is the only predictive factor of occult contralateral PTC, regardless of the size of primary tumor. However, there were no significant association between the presence of occult contralateral carcinoma and age, sex, perithyroidal invasion, lymphovascular tumor emboli, capsular invasion, central lymph node metastasis.
Conclusion:The presence of occult carcinoma in contralateral lobe in unilateral PTC is not related with the size of the primary tumor, but the multicentricity of primary tumor in ipsilateral lobe. If multicentric tumor in unilateral lobe was found during preoperative evaluation in micropapillary thyroid carcinoma, total thyroidectomy should be carefully considered.
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KEYWORD
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Thyroid papillary carcinoma, Thyroidectomy, Multicentricity
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