From the Guidelines
Papillary thyroid carcinoma is the most common type of thyroid cancer, accounting for approximately 89.8% of all thyroid malignancies, as reported in the most recent study from 2018 1. This cancer originates from the follicular cells of the thyroid gland and typically grows slowly, often remaining confined to the thyroid gland for many years. Some key points about papillary thyroid carcinoma include:
- It has a generally favorable prognosis with a 10-year survival rate exceeding 90% in most cases.
- The cancer is characterized microscopically by distinctive nuclear features including nuclear grooves, inclusions, and a ground-glass appearance.
- It tends to spread via lymphatic channels, which explains why cervical lymph node metastases are common at presentation, occurring in about 30-40% of patients.
- Risk factors include radiation exposure, particularly during childhood, and certain genetic predispositions.
- Treatment typically involves surgical removal of the thyroid (total or partial thyroidectomy), sometimes followed by radioactive iodine therapy, with excellent outcomes for most patients. The high prevalence of papillary thyroid carcinoma is consistent across different studies, with similar percentages reported in other research from 2015 1 and 2012 1, although the most recent and highest quality study from 2018 1 is used to inform this recommendation.
From the Research
Types of Thyroid Carcinoma
- Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy, accounting for approximately 80% of all thyroid cancers 2.
- It is associated with an excellent prognosis, with overall survival rates of more than 90% 3.
Characteristics of Papillary Thyroid Carcinoma
- PTC cells retain many of the features of native thyroid follicular cells, including the ability to produce thyroglobulin, be stimulated by thyroid-stimulating hormone (TSH), and take up iodine 3.
- These features are vital for clinical follow-up and treatment options, such as monitoring serum thyroglobulin levels and whole body radioactive iodine scans 3.
Treatment Options for Papillary Thyroid Carcinoma
- The first-line treatment for PTC is surgical excision, with total thyroidectomy being the recommended approach for most patients 3, 2.
- Radioactive iodine therapy is also effective for patients with total or nearly total thyroidectomy, particularly those with tumor >2 cm, age >45 years, and gross extrathyroidal or lymph node metastasis 4.
- Other treatment options include thyroid hormone suppression of TSH, external beam radiation, and chemotherapy, although these are less common 3.