Micropapillary thyroid cancer (mPTC): preliminary results of the first European, prospective, single-center observational trial

  • Background: Almost 50% of new thyroid cancer diagnosis are due to mPTC, probably undiagnosed before ultrasound introduction. Nowadays, the active surveillance can be considered an alternative to immediate surgery in mPTC.

    Patients and methods: on November 2014 we started an active surveillance program in mPTC. The inclusion criteria were a single thyroid nodule <1.3 cm at neck ultrasound (nUS) with a Thy4/Thy5 cytology and no evidence of metastatic lymphnodes. Patients were followed-up every 6 months.

    Results: Over 4 years 93/185 (50%) mPTC were enrolled. They were 72/93 (77%) females. The mean age was 44±15 yrs (18-82). Cytology was Thy4 and Thy5 in 55% and 45% of nodules, respectively. To date 19/93 (20%) patients withdrew the observation for personal reasons and opted for surgery without evidence of progression (median follow-up of 8 months). Three/93 (3%) patients showed a clinical progression and went to surgery with a successfull cure. Seventy-1/93 (76%) are still in follow-up (median 25 (6-54) months). No differences in clinical and epidemiological features were found between stable and progressive disease, except for nodule’s volume at baseline.

    Discussion and conclusion: The active surveillance for mPTC is feasible also in Europe. However, 20% of mPTC patients dropped out for personal reasons probably due to the negative impact of the diagnosis of cancer on their quality of life. Only 3% of patients showed a clinical progression. The nodule’s volume at the enrolment is relevant in predicting the progression. A delayed surgery did non impact on final outcome.

 

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