Risk factors for posttreatment recurrence in patients with intermediate-risk papillary thyroid carcinoma

Papillary thyroid carcinoma (PTC) is generally associated with favorable outcomes; however, intermediate-risk requires further evaluation. We therefore examined risk factors for posttreatment recurrence in patients with intermediate-risk PTC. This study involved 1782 patients who underwent thyroidec...

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Bibliographic Details
Published in:The American journal of surgery 2020-09, Vol.220 (3), p.642-647
Main Authors: Kim, Yonghan, Roh, Jong-Lyel, Song, Dong Eun, Cho, Kyung-Ja, Choi, Seung-Ho, Nam, Soon Yuhl, Kim, Sang Yoon
Format: Article
Language:English
Subjects:
Age
Biopsy
Cervical lymph node
Disease
Dissection
Histology
Intermediate risk
Iodine
Iodine radioisotopes
Lymph nodes
Lymphatic system
Metastases
Metastasis
Mortality
Multivariate analysis
Papillary thyroid carcinoma
Pathology
Patients
Predictive factors
Recurrence
Regression analysis
Risk analysis
Risk factors
Surgery
Thyroid
Thyroid cancer
Thyroidectomy
Tumors
Ultrasonic imaging
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Summary:Papillary thyroid carcinoma (PTC) is generally associated with favorable outcomes; however, intermediate-risk requires further evaluation. We therefore examined risk factors for posttreatment recurrence in patients with intermediate-risk PTC. This study involved 1782 patients who underwent thyroidectomy for intermediate-risk PTC. Univariate and multivariate Cox proportional hazard regression analyses were used to identify the significant factors predictive of posttreatment recurrence-free survival (RFS). Of intermediate-risk factors, univariate analyses showed that clinical and pathological cervical lymph node (LN) positivity (cN1 and pN1), aggressive histology, and multifocality with microscopic extrathyroidal extension were significantly associated with RFS outcomes (all P 5 pN1, and posttreatment radioactive iodine (RAI)-avid metastatic foci of intermediate risk remained the independent factors predictive of RFS (all P 5 pN1, lymphovascular invasion, RAI-avid foci, and aggressive histology were intermediate-risk factors.•cN1, >5 pN1, RAI-avid foci, aggressive histology, and multifocality w/ETE were associated with RFS.•cN1, >5 pN1, and RAI-avid metastatic foci remained independent factors for RFS.•Any three or more combined intermediate-risk factors significantly decreased RFS. This study evaluated risk factors for posttreatment recurrence in 1782 patients with intermediate-risk papillary thyroid carcinoma. Multivariate analyses determined clinical nodal positivity, >5 positive lymph nodes, and the presence of posttreatment radioactive iodine-avid metastatic foci in the ATA intermediate-risk category to be independent factors predictive of recurrence-free survival.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2020.01.049