Korean J Endocr Surg.  2010 Dec;10(4):261-265. 10.16956/kjes.2010.10.4.261.

A Study on the Risk Factors for Recurrence of Recurrent Papillary Thyroid Cancer after Surgery

• Ha TK
• Ryu SM
• Kim SH

• KMID: 2375480
• DOI: http://doi.org/10.16956/kjes.2010.10.4.261

Abstract

PURPOSE
Papillary thyroid carcinoma (PTC) is known to have a favorable prognosis and long-term survival due to its biologic characteristics of slow growth and late distant metastasis. However, its characteristic of lymph node metastasis has resulted in a high incidence of neck recurrence and only rare lung metastasis. The objective of this study is to analyze the characteristics of recurrent or persistent thyroid cancer and to evaluate the risk factors for the development of recurrence.
METHODS
We retrospectively reviewed 479 consecutive cases of PTC and these patients had undergone surgical operations from January 2004 to December 2006. We assessed age, gender, the tumor characteristics, the operative methods and the recurrence patterns, and the correlations between these factors and recurrence were analyzed.
RESULTS
Of the 479 patients with PTC and who were initially treated with surgery at our hospital, 42 patients (8.8%) had recurrent disease. Univariate analysis showed that an age less than 45 years, male gender, extra-thyroidal extension, lymph node metastasis, multifocality, bilaterality and neck node dissection were related to a higher rate of recurrence. Of these, lymph node metastasis and central or lateral neck node dissection were the independent risk factors for recurrent PTC on the multivariate analysis.
CONCLUSION
The significant factors influencing locoregional recurrence and distant metastasis were cervical lymph node metastasis and incomplete neck node dissection. In order to reduce the rate of recurrence of PTC, an exact preoperative evaluation of the nodal status and formal neck node dissection are recommended during the initial surgery in patients who have these factors of recurrence.

Keyword

Papillary thyroid carcinoma; Recurrence; Lymph node metastasis; Neck node dissection

MeSH Terms

Humans
Incidence
Lung
Lymph Nodes
Male
Multivariate Analysis
Neck
Neoplasm Metastasis
Population Characteristics
Prognosis
Recurrence*
Retrospective Studies
Risk Factors*
Thyroid Gland*
Thyroid Neoplasms*

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