Warning: fopen(/home/virtual/enm-kes/journal/upload/ip_log/ip_log_2023-10.txt): failed to open stream: Permission denied in /home/virtual/lib/view_data.php on line 88 Warning: fwrite() expects parameter 1 to be resource, boolean given in /home/virtual/lib/view_data.php on line 89
1Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
2Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA.
3Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.
Copyright © 2018 Korean Endocrine Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.
Adapted from Haugen et al. [7].
ATA, American Thyroid Association; PTC, papillary thyroid cancer; DM, distant metastases; RAI, radioactive iodine; WBS, whole body scan; N0, no evidence of regional lymph node metastasis; N1, metastasis to regional node; EFVPTC, encapsulated follicular variant of papillary thyroid cancer; WD-FTC, well differentiated follicular thyroid cancer; PMC, papillary microcarcinoma; ETE, extrathyroidal extension; LN, lymph nodes; Gross ETE, macroscopic invasion of tumor into the perithyroidal soft tissues; FTC, follicular thyroid cancer.
Previous features of low-risk thyroid cancer [20] | New features of low-risk thyroid cancer [79] |
---|---|
Low-risk for recurrence | Low-risk for recurrence |
PTC with all of the following: | All previous features of low-risk for recurrence PTC |
No local or DM | PTC with: clinical N0 or ≤5 pathologic N1 micro-metastases (<0.2 cm in largest dimension) |
All macroscopic tumor has been resected | Intra-thyroidal EFVPTC |
No tumor invasion of loco-regional tissues or structures | Intra-thyroidal WD-FTC with capsular invasion and no or minimal (<4 foci) vascular invasion |
No aggressive cyto-type (e.g., tall cell, hobnail variant, columnar cell carcinoma) | Intra-thyroidal PMC, unifocal or multifocal, including BRAFV600E mutated (if known) |
If RAI given, there are no RAI-avid metastatic foci outside the thyroid bed on the first post treatment WBS | Low-risk for mortality |
No vascular invasion | Age cut-off <55 years of age at diagnosis |
Minor ETE detected only on histological examination has no impact on either T category or overall stage | |
T3a tumors >4 cm confined to the thyroid gland, any N, M0 | |
T3b tumor of any size with gross ETE into strap muscles only (sternohyoid, sternothyroid, thyrohyoid, or omohyoid muscles), any N, M0 | |
Very low-risk tumors | |
PMC with no evidence of ETE nor metastases |
T3 tumors, >4 cm limited to the thyroid, or gross ETE invading only strap muscles (Stage II).
PTC, papillary thyroid cancer; DM, distant metastases; RAI, radioactive iodine; WBS, whole body scan; N0, no evidence of regional lymph node metastasis; N1, metastasis to regional node; EFVPTC, encapsulated follicular variant of papillary thyroid cancer; WD-FTC, well differentiated follicular thyroid cancer; PMC, papillary microcarcinoma; ETE, extrathyroidal extension; M0, no distant metastasis.
Adapted from Brito et al. [27].
US, ultrasound/ultrasonographic; ETE, extrathyroidal extension; cN0, clinically no lymph node; cM0, clinically no distant metastasis; FU, follow-up; PMC, papillary microcarcinoma; RLN, recurrent laryngeal nerve; LN, lymph node; FDG, fluorodeoxyglucose; FH, family history; FNA, fine needle aspiration; N1, metastasis to regional node; M1, distant metastasis; PTC, papillary thyroid cancer; TC, thyroid cancer.
Japan: Ito et al. (2014) [22] | Japan: Sugitani et al. (2010) [24] | USA: Tuttle et al. (2017) [28] | |
---|---|---|---|
No. of patients | 1,235 | 230 Patients and 300 lesions | 291 |
Tumor size cut-off, cm | ≤1 | ≤1 | ≤1.5 |
Time of follow-up | Mean, 6.25 years (range, 1.5–18.91) | Mean, 5 years (range, 1–17) | Median, 25 months (range, 6–166) |
At 10 year observation | |||
Ultrasound surveillance | 1–2/year | 1–2/year | 2/year for 2 years then 1/year |
Tumor increase by ≥3 mm, % | 8 | 7 | 3.8 |
Novel lymph node metastases, % | 3.8 | 1 | 0 |