Association of preoperative US features and recurrence in patients with classic papillary thyroid carcinoma

Soo Yeon Kim, Jin Young Kwak, Eun Kyung Kim, Jung Hyun Yoon, Hee Jung Moon

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: To investigate whether ultrasonographic (US) features of thyroid nodules are associated with tumor recurrence in classic papillary thyroid carcinoma (PTC). Materials and Methods: This retrospective study was approved by the Institutional Review Board, and the need to obtain informed consent was waived. A total of 515 patients (mean age, 45.8 years ± 13.2 [standard deviation]; range, 17-80 years) who underwent total thyroidectomy and central lymph node dissection for classic PTC greater than 10 mm from January 2003 to February 2006 and who were followed up for 12 months or longer were included. Malignant-appearing PTCs were defined as those showing at least one suspicious US feature among marked hypoechogenicity, irregular or microlobulated margin, microcalcifications, and taller-than-wide shape. Benign-appearing PTCs were defined as those without any suspicious US features. Kaplan-Meier cumulative-event curves for recurrence were compared by using the log-rank test. The multivariate Cox proportional hazard regression analysis was used to estimate hazard ratios (HRs) of the malignant-appearing US features for recurrence in the preoperative, postoperative, and combined models. Results: Fifty-six (10.9%) of 515 patients had recurrence. Malignant-appearing PTCs had lower 5-and 10-year diseasefree survival rates compared with benign-appearing PTCs (P =.01). In the preoperative model, malignant-appearing US features (HR, 3.523; 95% confidence interval [CI]: 1.263, 9.830) and larger nodule size (HR, 1.074; 95% CI: 1.051, 1.098) were independently associated with recurrence. In the combined model, male sex (HR, 1.990; 95% CI: 1.098, 3.610), malignant-appearing US features (HR, 2.828; 95% CI: 1.016. 7.870), larger nodule size (HR, 1.067; 95% CI: 1.043, 1.092), extrathyroidal extension (HR, 2.590; 95% CI: 1.160, 5.780), and lymph node metastasis (HR, 2.511; 95% CI: 1.163, 5.421) were independently associated with recurrence. Conclusion: The presence of malignant-appearing US features was independently associated with recurrence in patients with classic PTC.

Original languageEnglish
Pages (from-to)574-583
Number of pages10
JournalRadiology
Volume277
Issue number2
DOIs
StatePublished - 1 Jan 2015
Externally publishedYes

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Confidence Intervals
Factor IX
Recurrence
Calcinosis
Thyroid Nodule
Research Ethics Committees
Sex Ratio
Thyroidectomy
Papillary Thyroid cancer
Lymph Node Excision
Informed Consent
Survival Rate
Retrospective Studies
Lymph Nodes
Regression Analysis
Neoplasm Metastasis
Neoplasms

Cite this

Kim, Soo Yeon ; Kwak, Jin Young ; Kim, Eun Kyung ; Yoon, Jung Hyun ; Moon, Hee Jung. / Association of preoperative US features and recurrence in patients with classic papillary thyroid carcinoma. In: Radiology. 2015 ; Vol. 277, No. 2. pp. 574-583.
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title = "Association of preoperative US features and recurrence in patients with classic papillary thyroid carcinoma",
abstract = "Purpose: To investigate whether ultrasonographic (US) features of thyroid nodules are associated with tumor recurrence in classic papillary thyroid carcinoma (PTC). Materials and Methods: This retrospective study was approved by the Institutional Review Board, and the need to obtain informed consent was waived. A total of 515 patients (mean age, 45.8 years ± 13.2 [standard deviation]; range, 17-80 years) who underwent total thyroidectomy and central lymph node dissection for classic PTC greater than 10 mm from January 2003 to February 2006 and who were followed up for 12 months or longer were included. Malignant-appearing PTCs were defined as those showing at least one suspicious US feature among marked hypoechogenicity, irregular or microlobulated margin, microcalcifications, and taller-than-wide shape. Benign-appearing PTCs were defined as those without any suspicious US features. Kaplan-Meier cumulative-event curves for recurrence were compared by using the log-rank test. The multivariate Cox proportional hazard regression analysis was used to estimate hazard ratios (HRs) of the malignant-appearing US features for recurrence in the preoperative, postoperative, and combined models. Results: Fifty-six (10.9{\%}) of 515 patients had recurrence. Malignant-appearing PTCs had lower 5-and 10-year diseasefree survival rates compared with benign-appearing PTCs (P =.01). In the preoperative model, malignant-appearing US features (HR, 3.523; 95{\%} confidence interval [CI]: 1.263, 9.830) and larger nodule size (HR, 1.074; 95{\%} CI: 1.051, 1.098) were independently associated with recurrence. In the combined model, male sex (HR, 1.990; 95{\%} CI: 1.098, 3.610), malignant-appearing US features (HR, 2.828; 95{\%} CI: 1.016. 7.870), larger nodule size (HR, 1.067; 95{\%} CI: 1.043, 1.092), extrathyroidal extension (HR, 2.590; 95{\%} CI: 1.160, 5.780), and lymph node metastasis (HR, 2.511; 95{\%} CI: 1.163, 5.421) were independently associated with recurrence. Conclusion: The presence of malignant-appearing US features was independently associated with recurrence in patients with classic PTC.",
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Association of preoperative US features and recurrence in patients with classic papillary thyroid carcinoma. / Kim, Soo Yeon; Kwak, Jin Young; Kim, Eun Kyung; Yoon, Jung Hyun; Moon, Hee Jung.

In: Radiology, Vol. 277, No. 2, 01.01.2015, p. 574-583.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association of preoperative US features and recurrence in patients with classic papillary thyroid carcinoma

AU - Kim, Soo Yeon

AU - Kwak, Jin Young

AU - Kim, Eun Kyung

AU - Yoon, Jung Hyun

AU - Moon, Hee Jung

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Purpose: To investigate whether ultrasonographic (US) features of thyroid nodules are associated with tumor recurrence in classic papillary thyroid carcinoma (PTC). Materials and Methods: This retrospective study was approved by the Institutional Review Board, and the need to obtain informed consent was waived. A total of 515 patients (mean age, 45.8 years ± 13.2 [standard deviation]; range, 17-80 years) who underwent total thyroidectomy and central lymph node dissection for classic PTC greater than 10 mm from January 2003 to February 2006 and who were followed up for 12 months or longer were included. Malignant-appearing PTCs were defined as those showing at least one suspicious US feature among marked hypoechogenicity, irregular or microlobulated margin, microcalcifications, and taller-than-wide shape. Benign-appearing PTCs were defined as those without any suspicious US features. Kaplan-Meier cumulative-event curves for recurrence were compared by using the log-rank test. The multivariate Cox proportional hazard regression analysis was used to estimate hazard ratios (HRs) of the malignant-appearing US features for recurrence in the preoperative, postoperative, and combined models. Results: Fifty-six (10.9%) of 515 patients had recurrence. Malignant-appearing PTCs had lower 5-and 10-year diseasefree survival rates compared with benign-appearing PTCs (P =.01). In the preoperative model, malignant-appearing US features (HR, 3.523; 95% confidence interval [CI]: 1.263, 9.830) and larger nodule size (HR, 1.074; 95% CI: 1.051, 1.098) were independently associated with recurrence. In the combined model, male sex (HR, 1.990; 95% CI: 1.098, 3.610), malignant-appearing US features (HR, 2.828; 95% CI: 1.016. 7.870), larger nodule size (HR, 1.067; 95% CI: 1.043, 1.092), extrathyroidal extension (HR, 2.590; 95% CI: 1.160, 5.780), and lymph node metastasis (HR, 2.511; 95% CI: 1.163, 5.421) were independently associated with recurrence. Conclusion: The presence of malignant-appearing US features was independently associated with recurrence in patients with classic PTC.

AB - Purpose: To investigate whether ultrasonographic (US) features of thyroid nodules are associated with tumor recurrence in classic papillary thyroid carcinoma (PTC). Materials and Methods: This retrospective study was approved by the Institutional Review Board, and the need to obtain informed consent was waived. A total of 515 patients (mean age, 45.8 years ± 13.2 [standard deviation]; range, 17-80 years) who underwent total thyroidectomy and central lymph node dissection for classic PTC greater than 10 mm from January 2003 to February 2006 and who were followed up for 12 months or longer were included. Malignant-appearing PTCs were defined as those showing at least one suspicious US feature among marked hypoechogenicity, irregular or microlobulated margin, microcalcifications, and taller-than-wide shape. Benign-appearing PTCs were defined as those without any suspicious US features. Kaplan-Meier cumulative-event curves for recurrence were compared by using the log-rank test. The multivariate Cox proportional hazard regression analysis was used to estimate hazard ratios (HRs) of the malignant-appearing US features for recurrence in the preoperative, postoperative, and combined models. Results: Fifty-six (10.9%) of 515 patients had recurrence. Malignant-appearing PTCs had lower 5-and 10-year diseasefree survival rates compared with benign-appearing PTCs (P =.01). In the preoperative model, malignant-appearing US features (HR, 3.523; 95% confidence interval [CI]: 1.263, 9.830) and larger nodule size (HR, 1.074; 95% CI: 1.051, 1.098) were independently associated with recurrence. In the combined model, male sex (HR, 1.990; 95% CI: 1.098, 3.610), malignant-appearing US features (HR, 2.828; 95% CI: 1.016. 7.870), larger nodule size (HR, 1.067; 95% CI: 1.043, 1.092), extrathyroidal extension (HR, 2.590; 95% CI: 1.160, 5.780), and lymph node metastasis (HR, 2.511; 95% CI: 1.163, 5.421) were independently associated with recurrence. Conclusion: The presence of malignant-appearing US features was independently associated with recurrence in patients with classic PTC.

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