Understanding the natural history of papillary thyroid cancer: Case series

Papillary thyroid cancer (PTC) incidence continues to rise. We describe the natural history of untreated PTC patients. Retrospective case series of 31 untreated PTC patients. We identified 31 untreated patients from the Kaiser Permanente Cancer Registry with PTC from 1973 to 2010. Patients were categorized as low risk (n = 16), high risk (n = 12), or low risk but medically contraindicated for surgery (n = 3). At diagnosis, 7 (58.3%) in the high-risk group had cervical lymph node metastases and 5 (41.7%) had distant metastases, compared to none in the low-risk group. Among the latter, three (18.8%) patients developed tumor growth >3 mm and one (6.3%) developed regional lymph node metastases without distant metastases. The 10-year overall survival was 71% and 35% for the low-risk and high-risk groups, respectively. Patients with low-risk untreated PTC were less likely to develop new regional or distant metastases and had better overall survival than patients with high-risk untreated PTC. 4.

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