Role of preoperative assessment factors for decision-making on treatment modalities in papillary thyroid microcarcinoma with intermediate- and high-risk_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XIAO Siqi , WU Xianji , SHEN Keyu ,  ZHANG Guang

Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University; Jilin Provincial Key Laboratory of Surgical Translational Medicine; Jilin Provincial Engineering Laboratory of Thyroid Disease Prevention and Control, Changchun 130033, P. R. China;

Corresponding?author：

ZHANG Guang, Email: zhangguang@jlu.edu.cn

Keywords：

papillary thyroid microcarcinoma; preoperative assessment; risk stratification

DOI：

10.7507/1007-9424.202212004

Video：

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Objective To explore the role of preoperative evaluation indicators for decision-making on treatment modalities in papillary thyroid microcarcinoma (PTMC) with intermediate- and high-risk. Method The recent pertinent literatures on studies of risk factors influencing PTMC were collected and reviewed. Results The surgical treatment was advocated for the PTMC with intermediate- and high-risk. However, the intraoperative surgical resection range and the postoperative prognosis of patients were debated. The malignancy of cell puncture pathology was a key factor in determining the surgical protocol. The patients with less than 45 years old at surgery, male, higher body mass index, higher serum thyrotropin level, and multifocal and isthmic tumors, and nodule internal hypoecho, calcification, unclear boundary, and irregular morphology by ultrasound, as well as mutations in BRAF^V600E and telomerase reverse transcriptase gene were the risk factors for preoperative evaluation of PTMC with intermediate- and high-risk. Conclusions According to a comprehensive understanding of preoperative risk factors for PTMC with intermediate- and high-risk, it is convenient to conduct an accurate preoperative evaluation and fully grasp the patients’ conditions. Clinicians should formulate individualized surgical treatment plans for patients based on preoperative assessment and their own clinical experiences.

Citation： XIAO Siqi, WU Xianji, SHEN Keyu, ZHANG Guang. Role of preoperative assessment factors for decision-making on treatment modalities in papillary thyroid microcarcinoma with intermediate- and high-risk. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(5): 620-625. doi: 10.7507/1007-9424.202212004 Copy

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2. Wu Q, Zhang YM, Sun S, et al. Clinical and sonographic assessment of cervical lymph node metastasis in papillary thyroid carcinoma. J Huazhong Univ Sci Technolog Med Sci, 2016, 36(6): 823-827.
3. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid, 2016, 26(1): 1-133.
4. Baloch ZW, Asa SL, Barletta JA, et al. Overview of the 2022 WHO classification of thyroid neoplasms. Endocr Pathol, 2022, 33(1): 27-63.
5. 中國抗癌協會甲狀腺癌專業委員會(CATO). 甲狀腺微小乳頭狀癌診斷與治療中國專家共識(2016版). 中國腫瘤臨床, 2016, 43(10): 405-411.
6. 杞靈斌, 詹想想, 尹哲, 等. 甲狀腺微小乳頭狀癌的手術診療分析. 中國普外基礎與臨床雜志, 2016, 23(10): 1182-1184.
7. Zheng W, Wang X, Rui Z, et al. Clinical features and therapeutic outcomes of patients with papillary thyroid microcarcinomas and larger tumors. Nucl Med Commun, 2019, 40(5): 477-483.
8. Nixon IJ, Kuk D, Wreesmann V, et al. Defining a valid age cutoff in staging of well-differentiated thyroid cancer. Ann Surg Oncol, 2016, 23(2): 410-415.
9. Huang H, Xu S, Wang X, et al. Patient age is significantly related to distant metastasis of papillary thyroid microcarcinoma. Front Endocrinol (Lausanne), 2021, 12: 748238. doi: 10.3389/fendo.2021.748238.
10. Tang J, Liu HB, Yu L, et al. Clinical-pathological characteristics and prognostic factors for papillary thyroid microcarcinoma in the elderly. J Cancer, 2018, 9(2): 256-262.
11. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
12. 王巖巖, 李莉, 彭德峰, 等. 甲狀腺微小乳頭狀癌中央區淋巴結轉移的相關因素分析. 中華全科醫學, 2018, 16(8): 1268-1270, 1282.
13. 孔令欣, 王照華, 殷文斌, 等. 甲狀腺微小乳頭狀癌側頸淋巴結轉移相關危險因素與預測指標分析. 中國普通外科雜志, 2021, 30(5): 537-542.
14. Dong Y, Wang D, Luo Y, et al. Comprehensive evaluation of risk factors for lymph node metastasis in patients with papillary thyroid carcinoma. Oncol Lett, 2021, 21(3): 188. doi: 10.3892/ol.2021.12449.
15. Choi JS, Kim EK, Moon HJ, et al. Higher body mass index may be a predictor of extrathyroidal extension in patients with papillary thyroid microcarcinoma. Endocrine, 2015, 48(1): 264-271.
16. 馬琳, 孫慶賀, 張磊, 等. 體重指數對甲狀腺微小乳頭狀癌患病風險及嚴重程度的影響. 國際外科學雜志, 2018, 45(12): 800-805.
17. Aschebrook KB, Sabra MM, Brenner A, et al. Diabetes and thyroid cancer risk in the National Institutes of Health-AARP diet and health study. Thyroid, 21(9): 957-963.
18. Kust D, Stani?i? J, Mate?a N. Bethesda thyroid categories and family history of thyroid disease. Clin Endocrinol (Oxf), 2018, 88(3): 468-472.
19. 高培蓉, 張震. 超聲聯合CT診斷家族性甲狀腺微小乳頭狀癌的價值. 中國醫科大學學報, 2019, 48(5): 472-475.
20. Cao J, Chen C, Chen C, et al. Clinicopathological features and prognosis of familial papillary thyroid carcinoma—a large-scale, matched, case-control study. Clin Endocrinol (Oxf), 2016, 84(4): 598-606.
21. 馬奎, 夏穎. 職業性放射性甲狀腺癌病例診斷評價. 輻射防護通訊, 2021, 41(4): 44-46.
22. Iglesias ML, Schmidt A, Ghuzlan AA, et al. Radiation exposure and thyroid cancer: a review. Arch Endocrinol Metab, 2017, 61(2): 180-187.
23. Duque CS, Vélez A, Cuartas J, et al. Molecular profiling of papillary thyroid carcinomas in healthcare workers exposed to low dose radiation at the workplace. Endocrine, 2022, 76(1): 95-100.
24. 李偉, 安樹才, 王磊, 等. 多灶性PTMC與單灶性PTMC轉移的危險因素對比. 醫學理論與實踐, 2022, 35(6): 981-983.
25. 呂翠婷, 袁喆晨, 胡時雨, 等. 甲狀腺乳頭狀微小癌中央區淋巴結轉移臨床病理預測因素分析. 社區醫學雜志, 2022, 20(5): 258-262.
26. Kim KJ, Kim SM, Lee YS, et al. Prognostic significance of tumor multifocality in papillary thyroid carcinoma and its relationship with primary tumor size: a retrospective study of 2 309 consecutive patients. Ann Surg Oncol, 2015, 22(1): 125-131.
27. Sapuppo G, Grasso S, Di Benedetto G, et al. Is multifocality a risk factor in low-risk papillary thyroid cancer? Endokrynol Pol, 2022, 73(6): 928-934.
28. 吳元清, 林杰, 羅佳寶, 等. 甲狀腺微小乳頭狀癌淋巴結轉移和腺外侵犯的危險因素分析. 中華普外科手術學雜志(電子版), 2021, 15(3): 319-322.
29. 孫威, 賀亮, 張浩. 美國癌癥聯合委員會甲狀腺癌分期系統(第8版)更新解讀. 中國實用外科雜志, 2017, 37(3): 255-258.
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Role of preoperative assessment factors for decision-making on treatment modalities in papillary thyroid microcarcinoma with intermediate- and high-risk

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