Prognostic Comparison of Long-Term Outcomes and Nodal Recurrence for Persistent and Recurrent Differentiated Thyroid...

Area of Science:

• Oncology
• Surgical Oncology
• Endocrinology

Background:

• Differentiated thyroid cancer (DTC) generally has a favorable prognosis.
• Distinguishing between recurrent and persistent DTC is challenging due to common indeterminate lymph node findings.
• Limited research exists on the comparative prognosis of recurrent versus persistent DTC.

Purpose of the Study:

• To compare the prognosis and oncologic characteristics of recurrent versus persistent DTC.
• To identify factors influencing disease-free survival (DFS) and overall survival (OS) in these patient groups.

Main Methods:

• Retrospective cohort study of 265 patients undergoing re-operation for DTC.
• Exclusion of patients with distant metastasis at initial diagnosis.
• Comparison of clinical characteristics, lymph node metastasis patterns, DFS, and OS between recurrent and persistent DTC groups.

Main Results:

• Recurrent DTC showed higher rates of central lymph node metastasis, infield recurrence, and distant metastasis.
• Persistent DTC exhibited more lateral lymph node metastasis and outfield recurrence.
• Ten-year DFS was significantly lower in recurrent DTC (41.0%) than persistent DTC (67.9%).
• Recurrent DTC, older age, higher metastatic lymph node count, and incomplete resection were associated with decreased DFS.
• No significant difference in overall survival (OS) was observed between the two groups.

Conclusions:

• Recurrent DTC is associated with significantly poorer disease-free survival compared to persistent DTC.
• Overall survival does not differ significantly between recurrent and persistent DTC patients.