Prognostic factors in patients with papillary thyroid carcinoma

Papillary thyroid carcinomas are associated with metastases and decreased survival in a small group of patients.

The aim of this study is to determine the factors associated with recurrences/metastases in papillary thyroid carcinoma patients.

One hundred and thirty-one patients with papillary thyroid carcinoma were evaluated retrospectively. The diagnosis was papillary microcarcinoma (PMC) in 48 patients. All patients had undergone near-total/total thyroidectomy. Radioactive iodine was given to 103 patients. Age at diagnosis, gender, previous history of thyroid disease, tumor stage, histopathological characteristics of tumor and initial treatment strategies were evaluated.

Recurrences/metastases developed in 17 patients during follow-up. Recurrences developed at a significantly higher percentage in patients with a tumor stage >T1 and patients with lymph node metastasis at presentation. No significant difference was observed in recurrence ratio between patients with PMC and patients with a tumor diameter > or =1cm. In the Cox-regression analysis only the advanced tumor stage (>T1) and presence of lymph node metastases were found to be significant predictors for recurrence (univariate analysis, odds ratio =4.02 and 3.15, respectively). However, multivariate analysis did not reveal any significant independent predictors. According to the Kaplan- Meier survival analysis, lymph node metastases at presentation were associated with a decrease in recurrence-free survival at statistical significance (p=0.05). No mortality was observed during follow-up.

Papillary thyroid carcinoma leads to recurrences/metastases in a small group of patients. Initial characteristics of the patients--i.e. presence of lymph node metastases--may predict recurrences/metastases in these patients.