미세유두상 갑상선암의 예후인자 및 치료지침

The Prognostic Factors and Therapeutic Strategy for Papillary Thyroid Microcarcinoma

<B>Purpose: </B>The objectives of this study were to define the prognostic factors of papillary microcarcinoma of the thyroid (PMCT), to analyse their histopathologic and epidemiologic characteristics and to investigate the optimal therapeutic management. <B>Methods: </B>Our series included 254 consecutive patents who were affected by PMCT and who were operated on by the same surgeon between 1985 and 2002 among a total of 3,100 patients who underwent thyroid surgery. All the surgical specimens were examined in the same Department of Pathology. The prognostic factors were evaluated by uni- and multivariate statistical analyses. <P><B>Results:</B> The histopathologic characteristics such as vascular extension, infiltration into the adjacent parenchyma, a larger primary tumor (size &#8805;5 mm) or tumor in the thyroid capsule were all indicative of a poor prognosis. For the patents with poor prognostic factors and who were treated by partial thyroidectomy alone, the prevalence of recurrent disease was higher than that for the patients who were with treated by total thyroidectomy and 131 iodine admini</B>stration. <P><B>Conclusion:</B> According to the prognostic factors, different therapeutic modalities could be proposed to treat patients with pillary thyroid microcarcinoma. It is reasonable to perform total thyroidectomy and 131 iodine therapy for patients with PMCT and who have high risk factors. <B>(Ko</B><B></B><B>rean J Endocrine Surg 2008;8:177-182)</B>