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. 2021 Jun;41(3):236-242.
doi: 10.14639/0392-100X-N1412.

Predictive factors for recurrence of papillary thyroid carcinoma: analysis of 4,085 patients

Andre Ywata de Carvalho  1 , Hugo Fontan Kohler  1 , Camila Couto Gomes  2 , Jose Guilherme Vartanian  1 , Luiz Paulo Kowalski  1   3
Affiliations

Predictive factors for recurrence of papillary thyroid carcinoma: analysis of 4,085 patients

Andre Ywata de Carvalho et al. Acta Otorhinolaryngol Ital. 2021 Jun.

Abstract
in English, Italian

Objective: The incidence of papillary thyroid carcinoma (PTC) has increased in recent years and its treatment remains controversial. The objective of this study is to identify clinicopathological predictive factors of tumour recurrence.

Methods: We retrospectively analysed 4,085 patients who underwent thyroidectomy for PTC from 1996 to 2015. Patients were stratified according to American Thyroid Association (ATA) risk categories and clinicopathological features were evaluated to identify independent factors for recurrence.

Results: After a mean follow-up of 58.7 (range 3-256.5) months, tumour recurrence was diagnosed in 176 (4.3%) patients, mostly in lymph nodes. Distant metastasis occurred in 18 patients (0.4%). There were 3 (0.1%) cancer-related deaths. Multivariate analysis showed that tumour size >10 mm, multifocality, extrathyroidal extension and lymph node metastasis (all, P < 0.001) were independent risk factors for recurrence. Further, recurrence was identified in 1.6% of the ATA low-risk, 7.4% of the intermediate-risk and 22.7% of the high-risk patients (P < 0.001).

Conclusions: In PTC patients, tumour size >10 mm, multifocality, extrathyroidal extension and presence of lymph node metastasis as well as the ATA recurrence staging system effectively predict recurrence.

Fattori predittivi di recidiva di carcinoma papillare della tiroide: analisi di 4.085 pazienti.

Obiettivo: L’incidenza del carcinoma papillare tiroideo (PTC) è aumentata negli ultimi anni e il suo trattamento rimane controverso. L’obiettivo di questo studio è identificare i fattori predittivi clinicopatologici di recidiva tumorale.

Metodi: Abbiamo analizzato retrospettivamente 4.085 pazienti sottoposti a tiroidectomia per PTC dal 1996 al 2015. I pazienti sono stati stratificati in base alle categorie di rischio dell’American Thyroid Association (ATA) e le caratteristiche clinicopatologiche sono state valutate per identificare fattori indipendenti di recidiva.

Risultati: Dopo un follow-up medio di 58,7 (range, 3-256,5) mesi, la recidiva del tumore è stata diagnosticata in 176 pazienti (4,3%), principalmente nei linfonodi. Metastasi a distanza si sono verificate in 18 pazienti (0,4%). Ci sono stati 3 (0,1%) decessi correlati al cancro. L’analisi multivariata ha mostrato che le dimensioni del tumore > 10 mm, la multifocalità, l’estensione extratiroidea e le metastasi linfonodali (tutti, P < 0,001) erano fattori di rischio indipendenti per la recidiva. Inoltre, la recidiva è stata identificata nell’1,6% dei pazienti ATA a basso rischio, nel 7,4% dei pazienti a rischio intermedio e nel 22,7% dei pazienti ad alto rischio (P < 0,001).

Conclusioni: Nei pazienti con PTC, la dimensione del tumore > 10 mm, la multifocalità, l’estensione extratiroidea e la presenza di metastasi linfonodali, nonché il sistema di stadiazione delle recidive ATA, predicono efficacemente la recidiva.

Keywords: papillary carcinoma; recurrence; survival; thyroid.

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Conflict of interest statement

Conflict of interest

The Authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Temporal evolution of papillary thyroid carcinomas and proportion of microcarcinomas.
Figure 2.
Figure 2.
Pattern of recurrence of papillary thyroid carcinoma.
Figure 3.
Figure 3.
Kaplan-Meier recurrence estimates based on ATA risk categories.
See this image and copyright information in PMC

References

    1. Wiltshire JJ, Drake TM, Uttley L, et al. . Systematic review of trends in the incidence rates of thyroid cancer. Thyroid 2016;26:1541-1552. https://doi.org/10.1089/thy.2016.0100 10.1089/thy.2016.0100 - DOI - PubMed
    1. Hundahl SA, Fleming ID, Fremgen AM, et al. . A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985-1995. Cancer 1998;83:2638-2648. https://doi.org/10.1002/(sici)1097-0142(19981215)83:12<2618::aid-cncr... 10.1002/(sici)1097-0142(19981215)83:12<2618::aid-cncr29>3.0.co;2-h - DOI - PubMed
    1. Grogan RH, Kaplan SP, Cao H, et al. . A study of recurrence and death from papillary thyroid cancer with 27 years of median follow-up. Surgery 2013;154:1436-1446; discussion 1446-1447. https://doi.org/10.1016/j.surg.2013.07.008 10.1016/j.surg.2013.07.008 - DOI - PubMed
    1. Nabhan F, Ringel MD. Thyroid nodules and cancer management guidelines: comparisons and controversies. Endocr Relat Cancer 2017;24:R13-R26. https://doi.org/10.1530/ERC-16-0432 10.1530/ERC-16-0432 - DOI - PMC - PubMed
    1. Cooper DS, Doherty GM, Haugen BR, et al. . American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167-1214. https://doi.org/10.1089/thy.2009.0110 10.1089/thy.2009.0110 - DOI - PubMed