Postoperative recurrence of papillary thyroid carcinoma with lymph node metastasis

• Published in: Journal of surgical oncology 2015-08, Vol.112 (2), p.149-154
• Main Authors: Liu, Feng-Hsuan, Kuo, Sheng-Fong, Hsueh, Chuen, Chao, Tzu-Chieh, Lin, Jen-Der
• Format: Article
• Language: English
• Subjects: Adult; Aged; cancer specific survival; Carcinoma - blood; Carcinoma - mortality; Carcinoma - pathology; Carcinoma - radiotherapy; Carcinoma - surgery; Carcinoma, Papillary; Disease-Free Survival; Female; Follow-Up Studies; Humans; Iodine Radioisotopes - therapeutic use; Kaplan-Meier Estimate; lymph node dissection; Lymph Nodes - pathology; Lymph Nodes - surgery; Lymphatic Metastasis; Male; Middle Aged; Neck Dissection; Neoplasm Invasiveness; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - radiotherapy; Neoplasm Staging; Postoperative Period; radioactive iodine; Retrospective Studies; Risk Factors; Soft Tissue Neoplasms - diagnosis; Soft Tissue Neoplasms - radiotherapy; Soft Tissue Neoplasms - secondary; thyroglobulin; Thyroglobulin - blood; Thyroid Cancer, Papillary; Thyroid Neoplasms - blood; Thyroid Neoplasms - mortality; Thyroid Neoplasms - pathology; Thyroid Neoplasms - radiotherapy; Thyroid Neoplasms - surgery; Thyroidectomy; total thyroidectomy; Treatment Outcome
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.23967

Background and Objectives : The purpose of this study was to retrospectively analyze the features of patients with papillary thyroid carcinoma (PTC) presenting with neck lymph node (LN) metastasis. Methods : The study enrolled 909 patients with PTC who had undergone total thyroidectomy. After a median follow‐up of 14.6 years, 73 (8.0%) patients died of thyroid cancer. A total of 536 patients had the tumor confined to the thyroid (intra‐thyroid), 111 had lymph node (LN) metastasis, 225 showed soft tissue invasion, and 37 had distant metastasis. Results : Compared with the intra‐thyroid group, the group with LN metastases showed larger tumor size, higher postoperative thyroglobulin levels, advanced TNM stage, higher recurrence rates (5.2% vs. 31.5%), and higher disease‐specific mortality (1.3% vs. 12.6%). Of the 111 patients with PTC and LN metastases, 35 (31.5%) were diagnosed with recurrence during a mean follow‐up period of 16.9 ± 0.6 years. Among the 35 patients with recurrent PTC, 14 (40.0%) died of thyroid cancer. The mortality group was characterized by older, mostly male patients who presented with larger initial tumor size compared with survivors. Conclusions : In patients with PTC, the rates of recurrence and cancer mortality were higher in the group with LN metastasis than that in the intra‐thyroid tumor group. J. Surg. Oncol. 2015 111:149–154. © 2015 The Authors. Journal of Surgical Oncology Published by Wiley Periodicals, Inc.