ATA risk stratification shows utility in surgically treated thyroid microcarcinoma

  • Stefanova DI & al.
  • World J Surg
  • 11 oct. 2019

  • de Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • High-risk status according to American Thyroid Association (ATA) criteria is associated with increased risk for recurrence after surgery in patients with papillary thyroid microcarcinoma (PTMC), although low- and intermediate-risk patients had similar outcomes.

Why this matters

  • The relationship among ATA guidelines, appropriate treatment strategies, and outcomes is unclear.

Key results

  • 75.3% of patients underwent a total thyroidectomy and 24.7% received hemithyroidectomy.
    • Low-risk patients were more likely to undergo a hemithyroidectomy (30.5%) compared with intermediate- (12.9%) and high-risk (5.6%) patients.
    • High-risk patients were the most likely to undergo total thyroidectomy (94.4%) compared with intermediate- (87.1%) and low-risk (69.5%) patients.
  • ATA high-risk status was associated with increased risk of rising postoperative thyroglobulin levels after total thyroidectomy compared with intermediate- and low-risk status (40.0%, 5.1%, and 5.7%, respectively; P=.001).
  • High-risk status was associated with increased risk for structural recurrence after lobectomy or total thyroidectomy compared with intermediate- and low-risk status (16.7%, 0%, and 0%, respectively; P<.001>

Study design

  • 357 patients with PTCM, 246 classified as low risk by ATA criteria, 93 as intermediate risk, and 18 as high risk, were analyzed for outcomes after surgery.
  • Funding: None disclosed.

Limitations

  • Retrospective study.
  • Short follow-up (median, 17.5 months).