Can we rely on pathologic parameters to define conservative treatment of XXXX ?

@entity3557 @entity1377 @entity1496 @entity1 @entity5 @entity3
@entity3557 is the most common @entity5 and usually behaves in an indolent fashion. At most institutions these @entity5 are treated by near-total or total thyroidectomy followed by radioactive @entity1496 ablation. The 2 main reasons for this extensive treatment include high rate of multicentricity in @entity1377 and difficulty in ablating large thyroid remnants with radioactive @entity1496 after partial thyroidectomy. Some authors believe, however, that this treatment protocol may not be justified in all cases of @entity1377 . We analyzed 253 total thyroidectomies performed for @entity3557 for the following pathologic variables: @entity5 size, presence of @entity5 capsular and/or vascular invasion, intrathyroidal spread, @entity5 in the contralateral lobe, and lymph node @entity3 . @entity5 measuring less than 1 cm and those with extrathyroidal soft tissue extension were excluded from this study. Among 253 cases (197 females, 56 males, age range 14-88 years), the primary @entity5 size ranged from 1-9.5 cm; 162 cases were completely encapsulated. Tumor capsule invasion was seen in 139 (86%) and vascular invasion was present in 32 (13%) cases; of these 27 (11% of the total) @entity1 showed both @entity5 capsule and vascular invasion. Seventy-four (29%) @entity1 showed @entity5 in the contralateral lobe; in 35 (47%) of these cases the @entity5 measured less than 1.0 cm. Lymph nodes were sampled in 106 cases, @entity3 were present in 67 (67/106 = 63%) and only 16 cases with lymph node @entity3 showed @entity5 . No significant correlation was noted between @entity5 size, occurrence of @entity5 , and lymph node @entity3 . Seventy-one percent of cases included in this study failed to show @entity5 . Hence, pathologic parameters such as lack of vascular invasion and lack of multifocality may be used to identify @entity1 who can benefit from conservative therapy alone.
