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• W3048841454 abstract "The incidence of papillary thyroid microcarcinoma (PTMC) has increased in recent years, especially in patients operated on for presumably benign thyroid disease. The aim of this study was to analyze the differences between PTMC incidentally diagnosed and PTMC clinically diagnosed, as well as its long-term prognosis. The study population consisted of patients with a histological diagnosis of PTMC. Patients with previous thyroid surgery, other synchronous thyroid or extrathyroid malignancies and an ectopic location of PTMC were excluded. Two groups were compared: patients with PTMC incidentally diagnosed (group 1) and patients with PTMC clinically diagnosed (group 2). A multivariate analysis of differentiating factors was performed. PTMC clinically diagnosed had a high frequency of hypothyroidism (4,6% vs. 18,9%; p = 0,004), extrathyroidal extension (5,7% vs. 17,6%; p = 0,018), metastatic lymph nodes (1,1% vs. 18,9%; p < 0,001) and lymphocytic thyroiditis (5,7% vs. 27%; p < 0,001). In the multivariate analysis, metastatic lymph nodes (OR 22,011, IC95% 2,621-184,829; p = 0,004) and lymphocytic thyroiditis (OR 4,949, IC95% 1,602-15,288; p = 0,005) were associated with the clinical diagnosis of PTMC. During a mean follow-up of 119,8 ± 65,1 months, one recurrence was detected in group 2 (0 vs. 1,4%; p = 0,460). No patient died due to the disease. PTMC clinically diagnosed, although it has more aggressive histopathological characteristics (extrathyroidal extension and metastatic lymph nodes), presents a long-term prognosis similar to the PTMC incidentally diagnosed. The presence of metastatic lymph nodes and lymphocytic thyroiditis were independent factors associated with PTMC clinically diagnosed. La incidencia del microcarcinoma papilar de tiroides (MCPT) está aumentando en los últimos años, especialmente en pacientes intervenidos por enfermedad tiroidea presumiblemente benigna. El objetivo de este estudio es analizar las diferencias entre el MCPT de diagnóstico incidental y de diagnóstico clínico preoperatorio, así como su pronóstico a largo plazo. La población a estudio la constituyen los pacientes con diagnóstico histológico de MCPT. Se excluyeron los pacientes con cirugía tiroidea previa, con otras patologías tiroideas o extratiroideas malignas sincrónicas y localización ectópica del MCPT. Se compararon dos grupos: pacientes con diagnóstico incidental (grupo 1) y con diagnóstico clínico (grupo 2). Se realizó un análisis multivariante de los factores diferenciadores. El MCPT de diagnóstico clínico presentó mayor frecuencia de hipotiroidismo (4,6% vs. 18,9%; p = 0,004), invasión extracapsular (5,7% vs. 17,6%; p = 0,018), adenopatías metastásicas (1,1% vs. 18,9%; p < 0,001) y tiroiditis linfocitaria (5,7% vs. 27%; p < 0,001). En el análisis multivariante, la presencia de adenopatías metastásicas (OR 22,011, IC95% 2,621-184,829; p = 0,004) y la tiroiditis linfocitaria (OR 4,949, IC95% 1,602-15,288; p = 0,005) se asociaron con el diagnóstico clínico del MCPT. Durante un seguimiento medio de 119,8 ± 65,1 meses, se detectó una recidiva en el grupo 2 (0 vs. 1,4%; p = 0,460). Ningún paciente falleció debido a la enfermedad. El MCPT de diagnóstico clínico, aunque presenta características histopatológicas más agresivas (invasión extracapsular y de adenopatías metastásicas), presenta un pronóstico a largo plazo similar al MCPT incidental. La presencia de adenopatías metastásicas y tiroiditis linfocitaria fueron factores independientes asociados al MCPT de diagnóstico clínico." @default.
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• W3048841454 date "2020-05-01" @default.
• W3048841454 modified "2023-09-23" @default.
• W3048841454 title "Incidental versus clinical diagnosis of papillary thyroid microcarcinoma. Long-term prognosis" @default.
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• W3048841454 doi "https://doi.org/10.1016/j.endien.2019.09.003" @default.
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