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Updated: Aug 27, 2025
04:01
Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
875
[Risk factors for recurrence and survival analysis in locally advanced T4a papillary thyroid carcinoma after R0
Summary
Papillary thyroid carcinoma (PTC) stage T4a patients with complete tumor removal (R0 resection) show good outcomes. Key recurrence risks include preoperative recurrent laryngeal nerve palsy and lateral cervical lymph node metastasis.
Area of Science:
- Oncology
- Head and Neck Surgery
- Thyroid Cancer Research
Background:
- Locally advanced T4a papillary thyroid carcinoma (PTC) presents unique treatment challenges.
- Understanding recurrence risk factors is crucial for improving patient outcomes in T4a PTC.
Purpose of the Study:
- To evaluate treatment outcomes in T4a PTC patients.
- To identify risk factors associated with postoperative recurrence in T4a PTC.
Main Methods:
- Retrospective analysis of 185 T4a PTC patients (2006-2019).
- Kaplan-Meier survival analysis and logistic regression for recurrence risk factors.
- Assessment of invasion into adjacent structures (recurrent laryngeal nerve, trachea, esophagus).
Main Results:
- The 5-year and 10-year overall survival rates were 95.21% and 93.10%, respectively.
- Recurrence or metastasis occurred in 9.73% of patients, with a 4.86% mortality rate.
- Independent risk factors for recurrence included preoperative recurrent laryngeal nerve palsy (OR=3.27) and lateral cervical lymph node metastasis (OR=4.71).
Conclusions:
- T4a PTC patients achieving R0 resection demonstrate favorable treatment efficacy.
- Preoperative recurrent laryngeal nerve palsy and lateral cervical lymph node metastasis are significant independent risk factors for recurrence in T4a PTC.
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