Preoperative Clinical Factors Associated With High-Risk Features Predictive of Papillary Thyroid Cancer Recurrence

Area of Science:

• Oncology
• Endocrinology
• Radiology

Background:

• Papillary thyroid cancer (PTC) often has favorable outcomes, but a subset exhibits high-risk features linked to recurrence.
• Recurrence risks include vascular invasion, extrathyroidal extension, aggressive variants, and distant metastasis.

Purpose of the Study:

• To identify preoperative clinical factors associated with high-risk PTC tumor characteristics.
• To predict disease recurrence risk using the American Thyroid Association (ATA) risk stratification system.

Main Methods:

• Retrospective review of 762 patients undergoing thyroidectomy for PTC.
• Analysis of clinical variables including demographics, symptoms, nodule characteristics, and lymph node status.
• Stratification into ATA high/intermediate- and low-risk categories; logistic regression analysis.

Main Results:

• 42% of patients were classified as high/intermediate risk.
• Significant predictors of high-risk PTC included male sex, age <45, hypothyroid symptoms, coarse/microcalcifications, taller-than-wide nodules, and lymph node metastases.
• Odds ratios ranged from 1.64 to 3.64 for these factors.

Conclusions:

• Preoperative clinical and radiologic features significantly predict high-risk PTC tumor characteristics and recurrence.
• Early identification of these features can personalize risk stratification and inform surgical strategies.