Clinical Series of Patients with Micropapillary Thyroid Cancer

Rodrigo Arrangoiz MS, MD, FACS, FSSO

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  • The Mayo Clinic series includes:

    • 900 patients with an average follow-up of 17.2 years (range of 6 to 89 years):

      • 23% of the tumors were multifocal.

      • 17% bilateral.

      • 2% extrathyroidal.

      • 30% had nodal involvement.

      • 0.3% had distant metastatic disease.

    • Less than 25% were under 5 mm and over a third were 9 to 10 mm.

    • The 40-year cause specific mortalitywas 0.7:

      • All three patients who died presented with lymphadenopathy.

      • One had massive lymphadenopathy

      • One had pulmonary metastases upon presentation.

    • Recurrences occurred in 8% of patients:

      • Most in the cervical lymph nodes, but 1.5% occurred in the thyroid bed.

      • Nodal recurrences occurred in 16% of patients with positive nodes at presentation and only 0.8% of patients without nodes at presentation.

      • Recurrences occurred in 11% of patients with multifocal disease and 4% of patients with unifocal disease.

  • The Noguchi Thyroid Clinic in Japan series:

    • Included 2070 patients with an average follow-up of 15 years.

    • Recurrences occurred in 3.5% of patients at a mean of 10.3 years.

    • Distant metastases occurred in only 0.2% of patients.

    • Recurrence was more likely in patients with larger tumors (greater than 5 mm), more lymph nodes, and invasion (e.g., into the recurrent laryngeal nerve or esophagus), and less likely in patients with coexistent thyroid autoimmunity.

  • The series of 281 patients from the Gustave-Roussy Institute in France includes some patients with sub centimeter follicular thyroid cancers but demonstrates similar rates of recurrence:

    • 2.5% in cervical lymph nodes.

    • 1.4% in the thyroid bed.

  • The series of 203 patients from the Queen Elizabeth Hospital in Hong Kong reports a 4.9% rate of nodal recurrence and a 1% rate of local recurrences:

    • Two patients developed pulmonary metastases (1%), and two patients died.

    • The risk of lymph nodal recurrence was increased 6.2-fold when nodes were present at presentation and 5.6-fold when the tumor was multifocal.

    • The researchers did not find higher recurrencerates in tumors greater than 5 mm, but the larger micropapillary cancers were more likely to have extrathyroidal extension. 

  • Recurrence occurred in 4.8% of 293 patients reported from South Korea after a median follow-up of 65 months:

    • Cervical nodes at presentation were associated with an increased risk of recurrence.

  • Recurrence occurred in 3.1% of 287 patients from Rome, Italy, and included 2 patients (0.7%) with distant metastases; multifocal disease, extrathyroidal extension, and a higher number of cervical nodes at presentation were risk factors for recurrence.

  • Data from several series show:

    • Multifocality in 20% to 40% of patients.

    • Bilateral disease in 10% to 19% of patients.

    • Extra thyroidal invasion in 2% to 38% of patients,.

    • Cervical nodal involvement in 17% to 43% of patients:

    • Distant metastases in 0% to 3% of patients.

  • In one series of 671 patients from Seoul, Korea:

    • 24% had central nodal involvement.

    • 3.7% had lateral nodal involvement.

Thyroid Cancer Statistics

 

Rodrigo Arrangoiz MS, MD, FACS a head and neck surgeon and is a member of Sociedad Quirúrgica S.C at the America British Cowdray Medical Center in Mexico City:

  • He is an expert in the management of thyroid cancer.

Training:

• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016

http://www.cirugiatiroides.com

#Arrangoiz #HeadandNeckSurgery #EndocrineSurgery #SurgicalOncology #ThyroidSurgery #ThyroidCancerExpert #CirugiadeTumoresdeCabezayCuello #CirugiaEndocrina #CirugiadeTiroides #ExpertoenCancerdeTiroides #CancerSurgeon

 

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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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