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Total tumor diameter: the neglected value in papillary thyroid microcarcinoma

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Abstract

Background

Tumor multifocality is not uncommon in papillary thyroid carcinoma (PTC), especially in micro-PTC. However, assessing the size of the largest tumor may underestimate effect of additional foci. We aimed to investigate the effect of total tumor diameter (TTD) on clinicopathological features of micro-PTC.

Methods

Data from 442 patients who underwent thyroidectomy with cervical lymph node dissection for PTC were retrospectively analyzed. Patients were classified into subgroups according to multifocality and TTD. The relationships of clinicopathological features among these groups were analyzed.

Results

Multifocality was observed in 119 patients (26.9%). TTD > 1 cm and presence of extrathyroidal extension (ETE) were significantly higher in multifocal tumors compared to unifocal tumor (P < 0.001, P = 0.016, respectively). When comparing multifocal micro-PTC with TTD > 1 cm to those with unifocal micro-PTC or multifocal micro-PTC with TTD ≤ 1 cm, the proportions of cases with ETE, central lymph node metastasis (CLNM), and lateral lymph node metastasis (LLNM) were significantly higher (all P < 0.05). There was no significant difference in terms of these parameters between multifocal micro-PTC with TTD > 1 cm and macro-PTC or multifocal macro-PTC. The risk of CLNM was 2.056 (P = 0.044) times higher in multifocal micro-PTC with TTD > 1 cm than in unifocal micro-PTC.

Conclusion

For multifocal micro-PTC, TTD can better assess the aggressiveness of the tumor. Multifocal micro-PTC with TTD > 1 cm was more aggressive than unifocal micro-PTC or multifocal micro-PTC with TTD ≤ 1 cm.

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Acknowledgements

Lei Qin, the English language editor, was responsible for correcting language and grammar issues.

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Authors and Affiliations

  1. The Third Affiliated Hospital of Soochow University, Changzhou First People’s Hospital, Changzhou, Jiangsu, China

    J.-W. Feng, H. Pan, L. Wang, J. Ye, Y. Jiang & Z. Qu

Authors
  1. J.-W. Feng
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  2. H. Pan
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  3. L. Wang
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  4. J. Ye
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  5. Y. Jiang
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  6. Z. Qu
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Contributions

LW took charge of conceiving and designing the study; HP was responsible for collecting the data and analyzing and interpreting the data; J-WF took charge of writing the manuscript; JY was responsible for providing critical revisions; approving the final version of the manuscript was in charge of YJ and ZQ.

Corresponding authors

Correspondence to Y. Jiang or Z. Qu.

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Conflicts of interest

This manuscript has not been published nor submitted for publication elsewhere. All authors have contributed significantly, and agree with the content of the manuscript. The authors reported no proprietary or commercial interest in any product mentioned or concept discussed in this article.

Ethical approval

This study has been approved by the Institutional Review Board of Changzhou First People’s Hospital ethics committee, and has been performed according to the ethical standards laid down in the 1964 Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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Feng, JW., Pan, H., Wang, L. et al. Total tumor diameter: the neglected value in papillary thyroid microcarcinoma. J Endocrinol Invest 43, 601–613 (2020). https://doi.org/10.1007/s40618-019-01147-x

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  • DOI: https://doi.org/10.1007/s40618-019-01147-x

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