Abstract
Objectives
This study is designed to evaluate the usefulness of intraoperative frozen section for the evaluation of microscopic extrathyroidal extension (ETE) in papillary thyroid carcinoma (PTC).
Design
Retrospective cohort study.
Setting
Dong-A University Medical Center, Busan, Korea
Participants
Three hundred sixty-four patients who underwent thyroid surgery from January 2000 to December 2010, with PTC confined to one unilateral lobe as diagnosed using preoperative ultrasonography were enrolled.
Main outcome measures
The patients who had microscopic ETE on frozen section were classified into 'group A', and those who did not have microscopic ETE on frozen section were classified into 'group B' Clinicopathologic factors including age, gender, size of the tumor, extent of operation, ETE, multifocality, bilaterality, lymph node metastasis and recurrence were compared between the two groups.
Results
Of the 364 patients enrolled, ETE was confirmed in 100 patients (group A, 27.5%) on frozen biopsy. The nodule size in group A (0.94 ± 0.87 cm) was larger than that in group B (0.86 ± 0.79 cm) (p=0.042). In group A, 15 patients (15%) showed multifocality and 11 patients (14.47%) showed bilaterality. In group B, 37 patients (14.02%) showed multifocality and 7 patients (43.35%) showed bilaterality. They did not differ significantly between the two groups (p=0.811, p=0.182). There was a higher frequency of lymph node metastases in group A (52/86, 60.47%) than in group B (7/16, 43.75%, p=0.214). Recurrence was observed in only two patients who had received thyroid lobectomy as the initial surgery in group A.
Conclusions
Intraoperative frozen biopsy can be an useful method for identifying the microscopic ETE. During the surgery, it can also help the surgeon to decide the optimal extent of surgery and the need for CCND in PTC patients.
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