Notification of abstract acceptance
announced via E-mail on July 31st.
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Oct. 18 (Thu)  Grand Ballroom 101 Room - SS01 TH
10:10-10:20 [SS 01 TH-04] 
US criteria of the thyroid capsular continuity and contour for pre-operative assessment of extrathyroidal extension in papillary thyroid cancers
   
Speaker Jee Hyun Rim (Chung-Ang University Hospital)
Authors Jee Hyun Rim,Semin Chong,Sun Jin Lee,Han Suk Ryu,Kyungho Kang
Affiliation Chung-Ang University Hospital
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PURPOSE :

To suggest and evaluate the US criteria of the thyroid capsular continuity and contour for pre-operative assessment of extrathyroidal extension (ETE) in papillary thyroid cancers (PTC).


MATERIALS AND METHOD :

This study included 131 patients who underwent pre-operative US and total thyroidectomy for PTC with microscopic (n=89) or macroscopic (n=42) ETE. On US, we retrospectively evaluated the tumor size, the thyroid capsular continuity (C0, continuous; C1, discontinuous; C2, invisible) and contour (P0, apart from the capsule or intraparenchyme; P1, abutting; P2, bulging). We classified the thyroid capsular continuity and contour into nine types (Type 1, C0P0; Type 2, C0P1; Type 3, C0P2; Type 4, C1P0; Type 5, C1P1; Type 6, C1P2; Type 7, C2P0; Type 8, C2P1; Type 9, C2P2). We statistically analyzed the US findings of the thyroid capsular continuity and contour and its US classifications in microscopic and macroscopic ETE groups.


RESULTS :


In thyroid capsular continuity and contour, and its US classifications, there was significant difference between micro or macro ETE groups (p=0.013, p<0.001 and p=0.034). Continuous thyroid capsule or tumors abutted on the thyroid capsule was significantly associated with microscopic ETE (p=0.025 and p<0.001). Discontinuous thyroid capsule, bulging contour of the thyroid capsule tended to have macro ETE (p=0.021 and p<0.001). Of 9 types, there were no type 3, type 4 and type 7. Type 1 and type 8 were more likely microscopic ETE than macroscopic ETE (p=0.045 and p<0.001). Type 6 and type 9 were significantly associated with macro ETE (p<0.001 and p=0.017). The possibility of macroscopic extension was sixteen times in the bulging capsular contour than in the non-bulging contour (OR = 15.93, 95% CI : 4.58, 55.38; p<0.001). In the tumor size, macroscopic ETE had significantly large tumor size than microscopic ETE (p=0.027).


CONCLUSION :


PTCs abutting on thyroid capsule tended to have microscopic ETE. However, when PTCs with continuous or discontinuous capsule, there was no significant difference between microscopic and macroscopic ETE. On the other hand, PTCs with bulging contour regardless of capsular continuity more likely had macroscopic ETE than microscopic ETE.

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