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Prognosis after lymph node recurrence in papillary thyroid carcinoma depends on age
P E Voutilainen1, M M Multanen, A K Leppäniemi
1Department of Surgery, Helsinki University Central Hospital, Finland. petri.voutilainen@kolumbus.fi
Thyroid : Official Journal of the American Thyroid Association
|November 22, 2001
Summary
Papillary thyroid carcinoma (PTC) recurrence in lymph nodes has a good prognosis for patients under 45. However, for older patients, lymph node recurrence significantly worsens survival outcomes.
Area of Science:
- Endocrinology
- Oncology
- Surgical Oncology
Background:
- Papillary thyroid carcinoma (PTC) generally has a good prognosis, particularly in patients under 45.
- Lymph node recurrence (LNR) is observed in 10%-14% of PTC patients and is typically associated with a favorable outlook.
- Age at the time of primary surgery may influence disease behavior following LNR.
Purpose of the Study:
- To investigate the association between patient age at primary surgery and disease outcomes after lymph node recurrence (LNR) in papillary thyroid carcinoma (PTC).
Main Methods:
- Retrospective analysis of 495 PTC patients treated between 1967 and 1994.
- Inclusion of 58 patients who experienced LNR as the first sign of persistent disease.
- Comparison of survival rates based on age at primary operation (≤45 years vs. >45 years).
Main Results:
- Patients aged ≤45 at primary operation had a 100% 5-year and 10-year carcinoma-specific survival after LNR.
- Patients aged >45 had significantly lower survival rates: 61.1% at 5 years and 41.3% at 10 years (p < 0.0001).
- LNR negatively impacts survival in patients over 45, independent of other factors (Cox model, p < 0.001).
Conclusions:
- For PTC patients aged ≤45 at primary surgery, LNR does not significantly alter the prognosis, which remains similar to the general population.
- For PTC patients aged >45 at primary surgery, LNR is associated with a significantly poorer prognosis.
