OP67 – Clinical Impact of minimal extrathyroidal extension and others clinical factors as independent risk of recurrence and persistence disease in 1351 patients with papillary thyroid cancer


    Ozorio de Almeida, Maria Fernanda1; Ticly, Ana Luiza1; Ferraz, Carolina1; Cury, Adriano Namo1; Guardia, Vivian Cenize1; Scalissi, Nilza Maria1; Morone, Marília2; Padovani, Rosália do Prado1,2
    1 Endorinology Unit, Internal Medicine Department of Santa Casa de Sao Paulo, School of Medical Sciences
    2 Nuclear Medicine Service of Santa Casa  de Sao Paulo, School of Medical Sciences


    Background/Purpose: According to initial risk stratification proposed by 2015 American Thyroid Association (ATA) guideline, some clinic pathologic characteristics are response to increase the risk of recurrence/ persistence papillary thyroid cancer (PTC). Minimal extrathyroidal extension (mETE) is recognized as an isolated risk factor for poor prognosis. However, the impact of mETE as a prognostic independent risk factor remains controversial. The objective of this study is assess the impact of the mETE and others factors (sex, tumor size, age at diagnosis, multicentricity, radioactive iodine activity and initial stimulated thyroglobulin values) on PTC.

    Methods: 1351 PTC patients seen at the Nuclear Medicine Division at Santa Casa de São Paulo were included in this retrospective study and were classified as low risk or intermediate risk of recurrence just due the presence of mETE. Next, patients were divided according to underwent or not RAI therapy. Patients were classified according to the response to initial treatment using the ongoing risk stratification. Besides mETE, others risk factors were evaluated. Statistical analysis was made using SPSS 13.0 and qui-square and Mann-Whitney test.

    Results: mETE itself didn´t have impact on the response to initial therapy (p0.37) as others factors like sex (p0.85), multicentricity (p0.07) and age (p0,27). Greater tumor size (p0,02) and initial thyroglobulin >10ng/dL(p0.00) were associated with worst prognosis.

    Discussion & Conclusion: This study suggests that METE itself cannot be associated with risk of persistent/recurrent disease in DTC patients. Meanwhile the tumor size and the initial thyroglobulin value (>10ng/mL) are associated with poor prognosis suggesting more aggressive therapy and close follow-up.



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