While much research has been dedicated to understanding clinicopathologic characteristics that predict the recurrence of papillary thyroid cancer, much less is known about how sonographic imaging presentations impact prognosis.
Papillary thyroid carcinoma (PTC) has a favorable prognosis, with survival rates reaching more than 90% over 20 to 30 years. However, some patients—as many as 25% or more over a 10-year timeframe—experience regional or distant recurrence, which can degrade an individual’s quality of life and decrease positive outcomes.
Recently, experts from the Department of Ultrasound at the Affiliated Hospital of Qingdao University in China conducted an analysis of the imaging of nearly 900 patients with pathologically confirmed PTC to gain a better understanding of whether certain sonographic characteristics are indicative of patients’ risk cancer recurrence. In particular, the experts paid close attention to instances of extrathyroidal extension (ETE) on ultrasound.
Independent Predictors of PTC Recurrence:
Out of the 863 cases they studied, there was a recurrence rate of 6.8%. The experts observed several imaging characteristics that appeared to be associated with increased recurrence rates, including tumor size, microcalcifications, multifocality, ETE and node metastasis. Specifically, tumors with a maximum diameter greater than or equal to 20 mm, multifocality and lateral cervical lymph node metastasis were found to be independent risk factors.
The researchers noted that when interpreting the exams of patients with PTC, special attention should be paid to preoperative lateral cervical lymph nodes when ETE and extensive ETE are identified, but that microscopic ETE did not predict recurrence.
“Preoperative evaluation of tiny extrathyroidal invasion was difficult, but luckily, microscopic ETE has no correlation with preoperative cervical lymph node metastasis or tumor recurrence,” corresponding author of the paper, Chunping Ning, and colleagues explained.
The authors concluded by suggesting that patients with any of the aforementioned sonographic characteristics should be monitored closely and complete routine follow-ups, as their risk of recurrence is heightened.
The study abstract can be viewed in the European Journal of Radiology.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.