Number of tumor foci predicts prognosis in papillary thyroid cancer

BMC Cancer

Ning Qu¹  Ling Zhang¹  Qing-hai Ji¹  Yong-xue Zhu¹  Zhuo-ying Wang¹  Qiang Shen¹  Yu Wang¹  Duan-shu Li¹ 

[1] Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China

关键词: Mortality;    Recurrence;    Multifocality;    Papillary thyroid carcinoma;   

Others  :  1117949
DOI  :  10.1186/1471-2407-14-914

 received in 2014-07-14, accepted in 2014-11-26,  发布年份 2014

【 摘 要 】

Background

Papillary thyroid cancer (PTC) often presents as multifocal. However, the association of multifocality with poor prognosis remains controversial. The aim of this retrospective study was to identify the characteristics of PTC with multiple foci and to evaluate the association between multifocality and prognosis.

Methods

We reviewed the medical records of 496 patients who underwent total thyroidectomy for PTC. Patients were classified as G1 (1 tumor focus), G2 (2 foci), and G3 (3 or more foci). We analyzed the clinicopathological features and clinical outcomes in each classification. A Cox regression model was used to assess the relationship between multifocality and recurrence or cancer mortality.

Results

The G1, G2 and G3 groups included 287, 141 and 68 patients, respectively. The mean age was 47.1 ± 16.1 yr in G1, 41.1 ± 18.4 yr in G2, and 35.5 ± 15.9 yr in G3 and differed significantly among the 3 groups (p = 0.001). The proportion of extrathyroidal extension, central lymph node metastasis (CLNM), and lateral lymph node metastasis (LLNM) in the G1 to G3 groups increased with increasing number of tumor foci. The Kaplan–Meier curves revealed that G3 had the shortest recurrence-free survival, and differences were significant among the 3 groups (p = 0.001, Log Rank test). Furthermore, cancer-specific survival rates decreased significantly with increasing number of tumor foci (p = 0.041). Independent predictors of recurrence by multivariate Cox analysis included >3 tumor foci [HR 2.60, 95% confidence interval (CI) 1.53-4.39, p = 0.001] and extrathyroidal extension (HR 1.95, CI 1.12-3.38, p = 0.018).

Conclusion

An increase in the number of tumors is associated with a tendency toward more aggressive features and predicts poor prognosis in PTC.

【 授权许可】

   
2014 Qu et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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