March 06, 2013
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Ultrasound predicted biologic behavior of papillary thyroid cancer

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Ultrasound criteria have been used to differentiate benign from malignant thyroid lesions. However, researchers in Korea now suggest that ultrasound features at the time of a papillary thyroid cancer diagnosis can be a predictive tool for the biological behavior of the disease.

“Although papillary thyroid carcinomas usually carry a favorable prognosis, some tumors are progressive and become life-threatening for patients. It is useful to identify patients with poor prognosis using easily accessible parameters,” Sang Yu Nam, MD, of the department of radiology in Samsung Medical Center at Sungkyunkwan University School of Medicine in Seoul, Korea, and colleagues wrote.

They retrospectively reviewed the clinical records, histological data and ultrasound findings of index tumors among 488 patients who underwent surgery there for papillary thyroid carcinoma (PTC).

According to data, benign-looking PTCs justified 74 (15.2%) of 488 PTCs. Although the mean tumor size was not considered significantly different between the groups (1.1 cm for malignant-looking PTCs; 1.11 cm for benign-looking PTCs; P=.947), univariate and multivariate analyses demonstrated that malignant-looking PTCs displayed lymph node metastasis, extrathyroidal extension, and a higher stage more frequently compared with benign-looking PTCs (all P<.05). The researchers also reported significant size in tumors 1 cm or larger, but not in tumors smaller than 1 cm.

Additionally, the risk for recurrence was independently associated with lymph node metastasis (OR=4.362; 95% CI, 1.226-15.521) and larger tumor size (OR=1.769; 95% CI, 1.175-2.665), they wrote.

The researchers determined there was a greater chance for advanced age (P=.028), multifocality (P=.002), extrathyroidal extension (P<.001), lymph node metastasis (P=.007), a higher stage (P<.001), and receiving radioiodine therapy (P<.007) when the number of malignant ultrasound features increased.

Therefore, findings indicate ultrasound features could serve as an important differentiating factor in the diagnosis of PTC. Furthermore, ultrasound features have the potential to predict clinical outcomes or appropriate management of patients with PTC

Disclosure: The researchers report no relevant financial disclosures.