Is Male Gender a Prognostic Factor for Papillary Thyroid Microcarcinoma?

BACKGROUND: Male gender is a prognostic factor of poor outcome in papillary thyroid carcinoma (PTC). We investigated the prognostic role of male gender in papillary thyroid microcarcinoma (PTMC).

METHODS: We included 2930 patients who underwent surgery at Asan Medical Center for PTC. Clinicopathologic characteristics from the patients' medical records were compared for male and female PTC patients. Independent prognostic factors for recurrence in PTC and PTMC were evaluated after propensity score matching analysis. The median follow-up period was 82 months.

RESULTS: Recurrence and death were more common in male patients with PTC than in female patients with PTC (12.6 vs. 9.6%, p = 0.03 and 2.2 vs. 0.6%, p < 0.001, respectively). However, there was no difference in disease-free survival between male and female PTMC patients (p = 0.57). Multivariate analysis after propensity score matching revealed that male gender is not an independent prognostic factor of recurrence in PTMC (hazard ratio [HR] 1.5, 95% confidence interval 0.75-5.33, p = 0.17), but that it is an independent prognostic factor in PTC >1 cm (HR = 3.06, 95% confidence interval 1.34-6.98, p = 0.008).

CONCLUSIONS: Male gender is an independent prognostic factor for recurrence in PTC >1 cm, but it is not a prognostic factor in PTMC.