Q) Not an important prognostic factor in Carcinoma thyroid (JIPMER) A. Age B. Completeness of resection C. Multicentricity D. Extra thyroid extension
Ans c
MOst of the papillary carcinoma are multicentric any way
As per AGES And AMES criteria.
HIgh risk - Male. Age more than 40 years, Size more than 4 cm, Capsular or extra thyroid extension, Regional or distant metastasis and poor differentiation
Low Risk - Well differentiated less than 2 cm. Age benefit is extended to 50 yrs in women
Ref ( Sabiston page page 903)
IN younger patients (<45 years old), the presence of lymph node metastases had no effect on the excellent overall survival, but the presence of lymph node metastases increased the risk of death by 46% in patients older than 45
The presence of lymph node metastasis in patients with contained intrathyroidal primary papillary carcinoma also does not affect long-term survival.
If there is gross or microscopic extension of a primary PTC through the thyroid capsule, a poor prognosis and possibly a higher rate of lymph node metastasis may be anticipated.