Patterns of Initial Recurrence in Completely Resected Papillary Thyroid Carcinoma

Area of Science:

• Oncology
• Surgical Oncology
• Endocrinology

Background:

• Papillary thyroid carcinoma (PTC) can recur structurally despite optimal treatment.
• Identifying recurrence patterns is crucial for patient management.

Purpose of the Study:

• To evaluate the timing and patterns of structural recurrence in completely resected PTC patients.
• To identify clinicopathologic factors associated with different recurrence patterns.

Main Methods:

• Retrospective review of 2250 PTC patients (>1 cm) with complete remission.
• Analysis of recurrence timing, patterns (lymph node, local, distant), and predictive factors.
• Univariate and multivariate analyses performed.

Main Results:

• 3.0% of patients experienced structural recurrence over 8.1 years mean follow-up.
• Lymph node recurrence (LNR) was most common (53/68), followed by local (LR) and distant recurrence (DR).
• Younger patients had more LNR; older patients had more LR/DR. LNR peaked 1-3 years post-remission, LR/DR 2-4 years. Multifocal tumors and lymph node metastasis increased LNR risk; older age, larger tumors, and lateral metastasis increased LR/DR risk. Central neck dissection reduced LR/DR.

Conclusions:

• Recurrence patterns in PTC are diverse and linked to specific patient and tumor characteristics.
• Understanding recurrence timing and patterns can optimize adjuvant therapies and long-term surveillance strategies.