Long-term follow-up ultrasonography surveillance in a large cohort of patients with papillary thyroid carcinoma

• Published in: Endocrine 2022-08, Vol.77 (2), p.297-304
• Main Authors: Zhang, Jing-Wen, Fei, Meng-Jia, Hou, Yi-Qing, Tang, Zhen-Yun, Zhan, Wei-Wei, Zhou, Jian-Qiao
• Format: Article
• Language: English
• Subjects: Diabetes; Endocrinology; Humanities and Social Sciences; Internal Medicine; Lymph nodes; Lymphatic system; Medicine; Medicine & Public Health; multidisciplinary; Original Article; Papillary thyroid carcinoma; Patients; Risk factors; Science; Surgery; Surveillance; Survival; Survival analysis; Thyroid; Thyroid cancer; Tumors; Ultrasonic imaging
• ISSN: 1559-0100; 1355-008X; 1559-0100
• DOI: 10.1007/s12020-022-03071-2

Objective This study aimed to investigate the predictive factors as well as the time and age course of recurrence/persistence in a large cohort of postoperative patients with papillary thyroid carcinoma (PTC) based on the long-term ultrasonography (US) follow-up data. Methods Between January 2007 and December 2016, 3106 patients underwent surgery for PTC and at least two postoperative US follow-up examination over more than three years. Tumor recurrence/persistence was confirmed based on the follow-up US data and histopathological results. Univariate and multivariate analyses were performed to evaluate the predictive factors of tumor recurrence/persistence. Kaplan–Meier survival analysis was used to evaluate the recurrence-/persistence-free survival curve based on the US results. Results A total of 321(10.3%) patients developed tumor recurrence/persistence during 54.3 months of mean follow-up (range 36–135 months), including 268(83.5%) cases of lymph node recurrence/persistence, 37 (11.5%) cases of non-lymph node recurrence/persistence, and 16(5%) cases of both types. Recurrence/persistence was observed using US examination at a mean interval of 23.6 ± 21.6 months (range 1–135 months) after surgery and peak incidence was observed 1–2 years after initial treatment. Younger (20–30 years old) and older (70–80 years old) patients had a higher proportion of tumor recurrence/persistence. Multifocality, advanced T and advanced N stages were independent risk factors of tumor recurrence/persistence. Conclusion Tumor recurrence/persistence of PTC usually occurs during the early postoperative period. For patients with multifocal cancer, advanced T and N stage, the US surveillance examination should be cautiously performed, especially in younger and older patients.