Bilaterality as a Risk Factor for Recurrence in Papillary Thyroid Carcinoma

Area of Science:

• Endocrinology
• Oncology
• Surgical Oncology

Background:

• Multifocality in papillary thyroid carcinoma (PTC) is linked to recurrence risk.
• The specific impact of bilaterality in PTC on recurrence remains less understood.

Purpose of the Study:

• To investigate the association between tumor bilaterality and recurrence in patients with papillary thyroid carcinoma.
• To determine if bilaterality is an independent predictor of PTC recurrence.

Main Methods:

• Retrospective analysis of 1258 patients with PTC who underwent total thyroidectomy between 2011 and 2018.
• Kaplan-Meier survival analysis and multivariable Cox proportional hazards modeling were used to assess recurrence risk.

Main Results:

• The 5-year recurrence-free survival rate was 95.7% for bilateral PTC, 97.0% for unilateral multifocal PTC, and 97.8% for unifocal PTC (p=0.004).
• Bilaterality (HR 2.550), male sex (HR 2.010), and tumor size (HR 1.748) were independently associated with recurrence.
• Unilateral multifocality did not significantly increase recurrence risk (HR 1.211).

Conclusions:

• Bilaterality in PTC is associated with aggressive features like larger tumor size and microscopic extrathyroidal extension.
• Tumor bilaterality is an independent predictor of recurrence in papillary thyroid carcinoma patients.
• Patients with bilateral PTC may necessitate tailored treatment and vigilant follow-up strategies.