EVALUATION OF PROGNOSIS IN MULTIFOCAL HIGHLY DIFFERENTIATED THYROID CARCINOMAS ACCORDING TO THE TNM SYSTEM
DOI:
https://doi.org/10.11603/mie.1996-1960.2016.3.6760Keywords:
thyroid cancer, multifocal carcinoma, surgical treatmentAbstract
The comparative analysis of mono- and multifocal highly differentiated thyroid carcinoma (papillary and follicular) according to the TNM system was conducted. There were analyzed 2208 cases of monofocal and 692 cases of multifocal lesions in total. The analysis demonstrated that multifocal carcinomas, unlike solitary lesions, were characterized by a more aggressive course. Multicenter lesion by rubrics T, N and M with certainty at 99 % and more had higher indices than monofocal. Thus, T2 stage was recorded at 20.4 % of multifocal carcinomas versus 15.7 % for monofocal. The difference in T3 stage was also significant (22.4 % vs. 18.8 % respectively). In cases of T4 stage percent difference was 6.9 % with 5.0 % of multifocal and monofocal with thyroid carcinomas. N1a stage was recorded in 16.2 % of cases of multifocal carcinomas compared with 13.7 % for monofocal. Even more significant was the difference in N1b category - 15.7 % among multifocal that only 8.7 % of monofocal thyroid carcinomas. Distant metastases in patients with mono- and multifocal carcinoma were detected in isolated cases and this group of patients did not differ significantly from one another in such case (p > 0.05). The main conclusion is the need for more radical tactics of treatment in these cases.
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