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Recurrent papillary thyroid cancer: analysis of prognostic factors including the histological variant
S Ortiz1, J M Rodríguez, P Parrilla
1Hospital Universitario Virgen de la Arrixaca (Murcia), Servicio de Cirugía General y Aparato Digestivo (I), El Palmar, Spain.
Objective:
To analyse the factors that influence the development of recurrent papillary thyroid carcinoma, including the histological variant.
Design:
Retrospective study.
Setting:
Teaching hospital, Spain.
Subjects:
200 patients who had papillary thyroid cancers resected between 1970 and 1995.
Main Outcome Measures:
Prognostic factors and disease-free interval assessed by univariate and multivariate analysis.
Results:
All patients were followed up for a mean of 9 years (range 4-29). 54 patients presented with recurrent disease (27%) of whom 19 (35%) died of their disease. 5-year, 10-year, and 15-year survival for those with recurrent disease were 75%, 68%, and 60%, respectively. The corresponding figures for the whole series were 93%, 90%, and 84%. The significant variables on multivariate analysis were completeness of resection (p = 0.002), extrathyroid involvement (p < 0.002), presence of lymph node metastases (p = 0.002), and histological variant of the carcinoma (P < 0.001).
Conclusion:
Using these risk factors it is possible to draw up a prognostic index and classify patients as being at low, medium, or high risk of recurrence.