Retrospective Study Of Prognostic Factors And Surgical Extent For Papillary Thyroid Microcarcinoma

Objective:To study the prognostic factors and surgical extent of thyroid gland and neck lymph node dissection for papillary thyroid microcarcinoma(PTMC). To make reference for prognosis and the choices of surgical extent to PTMC. Methods:To search the Chinese literatures with the series database of CNKI(1979-2010). To search the English literatures with the series database of OVID, Pumed, EBSCO, EMBASE, Springer Link, Science Direct. To determine the relationships between prognostic factors and recurrence after initial operation by meta-analysis. Discuss the surgical extent for PTMC. Results: Randomized controlled trials and case-control studies have not been got. A total of 12 retrospective studies were included. Results of meta-analysis show that factors such as males, tumor size> 5mm, nonincidental, positive lymphnode, multifocal, capsular invasion are related with the recurrence after initial surgery. Age above 45 years has nothing to do with the recurrence rate of PTMC. There's no significant difference in rate of recurrence between prophylactic neck dissection groups and the groups without prophylactic neck dissection. Conclusion:The recurrence after initial surgery of PTMC are related with males, tumor size, nonincidental, positive lymphnode, multifocal, capsular invasion, but not with age. The patients with one or more risk factors should be held total or subtotal thyroidectomy, and the unilateral lobectomy should be given to the patients without any risk factors. Prophylactic neck dissection should not be used as conventional surgical for PTMC. Bilateral central lymph node dissection is appropriate to PTMC with positive lymphnode. Patients with PTMC should be given integrated estimation to their prognosis for appropriate postoperative treatment.