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Can N, Bulbul BY, Ozyilmaz F, Sut N, Mercan MA, Andaç B, Celik M, Tastekin E, Guldiken S, Sezer YA, Salt SA, Erdoğan EG, Ustun F, Gurkan H. The Impact of Total Tumor Diameter on Lymph Node Metastasis and Tumor Recurrence in Papillary Thyroid Carcinomas. Diagnostics (Basel) 2024; 14:272. [PMID: 38337788 PMCID: PMC10854897 DOI: 10.3390/diagnostics14030272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/20/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Introduction: The impact of multifocality/bilaterality on the prognosis of papillary thyroid carcinoma (PTC) is a matter of debate. In order to clarify this debate, several studies have attempted to identify additional parameters associated with poor prognosis, including total tumor diameter (TTD), in the context of multifocal PTCs. In this context, this study was carried out to investigate the impact of TTD on tumor recurrence and lymph node metastasis (LNM) in PTCs. (2) Materials and Methods: The sample of this single-center retrospective study consisted of 706 patients diagnosed with PTC. TTD was calculated as the sum of the largest diameters of tumor foci in multifocal tumors. The resulting TTDs were grouped into TTDs ≤ 10 mm, TTDs > 10 mm, TTDs ≤ 20 mm, and TTDs > 20 mm, using 10 mm and 20 mm as cutoff values. (3) Results: There was no significant difference between multifocal papillary microcarcinomas (PTMCs) with a TTD of >10 mm and unifocal PTCs with a primary tumor diameter (PTD) of >10 mm except for advanced age and lymphovascular invasion (LVI). In addition, perineural invasion (PNI) and TTD > 10 mm were found to be significant risk factors for LNM, and PNI, TTD > 10 mm, TTD > 20 mm, and bilaterality were found to be significant risk factors for recurrence. LVI, and TTD > 10 mm were found to be independent significant predictors for recurrence, and LVI and extrathyroidal extension (ETE) were found to be independent significant predictors for LNM. (4) Conclusions: Considering TTD > 10 mm in recurrence risk categorization models and adopting a clinical approach that takes into account multifocal PTMCs with TTD > 10 mm along with unifocal PTCs with PTD > 10 mm may be more useful in terms of clinical management of the disease.
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Affiliation(s)
- Nuray Can
- Department of Pathology, Faculty of Medicine, Trakya University, 22030 Edirne, Türkiye; (F.O.); (M.A.M.); (E.T.); (E.G.E.)
| | - Buket Yilmaz Bulbul
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine, Trakya University, 22030 Edirne, Türkiye; (B.Y.B.); (B.A.); (M.C.); (S.G.)
| | - Filiz Ozyilmaz
- Department of Pathology, Faculty of Medicine, Trakya University, 22030 Edirne, Türkiye; (F.O.); (M.A.M.); (E.T.); (E.G.E.)
| | - Necdet Sut
- Department of Biostatistics, Faculty of Medicine, Trakya University, 22030 Edirne, Türkiye;
| | - Meltem Ayyıldız Mercan
- Department of Pathology, Faculty of Medicine, Trakya University, 22030 Edirne, Türkiye; (F.O.); (M.A.M.); (E.T.); (E.G.E.)
| | - Burak Andaç
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine, Trakya University, 22030 Edirne, Türkiye; (B.Y.B.); (B.A.); (M.C.); (S.G.)
| | - Mehmet Celik
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine, Trakya University, 22030 Edirne, Türkiye; (B.Y.B.); (B.A.); (M.C.); (S.G.)
| | - Ebru Tastekin
- Department of Pathology, Faculty of Medicine, Trakya University, 22030 Edirne, Türkiye; (F.O.); (M.A.M.); (E.T.); (E.G.E.)
| | - Sibel Guldiken
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine, Trakya University, 22030 Edirne, Türkiye; (B.Y.B.); (B.A.); (M.C.); (S.G.)
| | - Yavuz Atakan Sezer
- Department of General Surgery, Faculty of Medicine, Trakya University, 22030 Edirne, Türkiye;
| | - Semra Ayturk Salt
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Kayseri City Hospital, 38080 Kayseri, Türkiye;
| | - Ezgi Genç Erdoğan
- Department of Pathology, Faculty of Medicine, Trakya University, 22030 Edirne, Türkiye; (F.O.); (M.A.M.); (E.T.); (E.G.E.)
| | - Funda Ustun
- Department of Nuclear Medicine, Faculty of Medicine, Trakya University, 22030 Edirne, Türkiye;
| | - Hakan Gurkan
- Department of Medical Genetics, Faculty of Medicine, Trakya University, 22030 Edirne, Türkiye;
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