WEDNESDAY, March 11, 2020 (HealthDay News) — Almost 19 percent of adult patients with papillary thyroid microcarcinoma (PTMC) present with advanced features, according to a study published online March 6 in the Journal of the American College of Surgeons.

Zaid Al-Qurayshi, M.D., M.P.H., from the University of Iowa Hospitals and Clinics in Iowa City, and colleagues examined the risk for advanced PTMC at presentation in a retrospective analysis using the National Cancer Database (2010 to 2014). Data were included for 30,180 adult patients with PTMC.

The researchers found that 5,628 patients (18.7 percent) presented with advanced features, including central lymph node (LN) metastasis, lateral LN metastasis, microscopic extrathyroidal extension (ETE), gross ETE, lymphovascular invasion, and distant metastasis (8.0, 4.4, 6.7, 0.3, 4.4, and 0.4 percent, respectively). With the exception of ETE and lymphovascular invasion, all these features were associated with significantly lower survival. Significant interrelation was seen among these features; distant metastasis was associated with central LN metastasis, lateral LN metastasis, and gross ETE (odds ratios, 2.44, 3.18, and 9.91, respectively). Nodal metastasis was associated with microscopic ETE and lymphovascular invasion (odds ratios, 3.82 and 7.17, respectively).

“The study provides a good, general perspective about the landscape of PTMC,” Al-Qurayshi said in a statement. “More granular, clinical data are needed to help understand the risk factors for advanced disease and develop a preoperative test that could identify these patients who have them.”

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