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KMID : 0361020210640100734
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Korean Journal of Otolaryngology - Head and Neck Surgery
2021 Volume.64 No. 10 p.734 ~ p.740
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Prediction of Gross Extrathyroidal Extension Using Preoperative Ultrasonography in Papillary Thyroid Cancer
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Seo Hyo-Seok
Cheon Yong-Il
Kwon Hyun-Keun
Shin Sung-Chan
Seo Myeong-Gu
Cho Young-Jin
Sung Eui-Suk
Lee Jin-Choon
Kim Bo-Hyun
Kim In-Ju
Lee Byung-Joo
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Abstract
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Background and Objectives The American Joint Committee on Cancer (AJCC) stagingsystem 8th Edition has stated that gross extrathyroid extension (ETE) is more important thanmicroscopic ETE, and that it plays an important factor in the classification of T stages. Therefore,the prediction of gross ETE before surgery is important in establishing the clinical stageand determining the surgical extent. However, there are few studies predicting gross ETE usingpreoperative ultrasonography (US). The purpose of this study is to predict the gross ETEof papillary thyroid carcinoma (PTC) using preoperative US.
Subjects and Method The preoperative US findings of 688 patients with PTC were comparedwith gross ETE confirmed during the surgery. The efficacy of preoperative US was statisticallyanalyzed.
Results A total of 70 (10%) patients were confirmed of their gross ETE. Thyroid tumorswere classified into three groups (isolation, capsular contact, and capsular protrusion) accordingto their relationship with capsules, and evaluated using the preoperative US. There was asignificant difference in gross ETE between groups (p<0.001). The thyroid tumor that cameinto contact with the capsule or protruded in the anterior region showed a difference betweenthe capsular contact and capsular protrusion groups (p<0.001), whereas those came into contactwith the capsule or protruded in the posterior region showed no significant difference betweenthe two groups (p=0.187). There was no difference in the degree of protrusion (<25%,25-50%, ≥50%) in the capsular protrusion group (p=0.868), but the difference in tumor sizewas significant (p<0.001).
Conclusion Preoperative US is a useful tool for predicting gross ETE and is more predictablewhen the thyroid tumor is located anteriorly.
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KEYWORD
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Extrathyroidal extension, Papillary thyroid carcinoma, Predictive, Ultrasonography
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