Recurrent papillary thyroid cancer: analysis of prognostic factors including the histological variant.

OBJECTIVE

To analyse the factors that influence the development of recurrent papillary thyroid carcinoma, including the histological variant.

DESIGN

Retrospective study.

SETTING

Teaching hospital, Spain.

SUBJECTS

200 patients who had papillary thyroid cancers resected between 1970 and 1995.

MAIN OUTCOME MEASURES

Prognostic factors and disease-free interval assessed by univariate and multivariate analysis.

RESULTS

All patients were followed up for a mean of 9 years (range 4-29). 54 patients presented with recurrent disease (27%) of whom 19 (35%) died of their disease. 5-year, 10-year, and 15-year survival for those with recurrent disease were 75%, 68%, and 60%, respectively. The corresponding figures for the whole series were 93%, 90%, and 84%. The significant variables on multivariate analysis were completeness of resection (p = 0.002), extrathyroid involvement (p < 0.002), presence of lymph node metastases (p = 0.002), and histological variant of the carcinoma (P < 0.001).

CONCLUSION

Using these risk factors it is possible to draw up a prognostic index and classify patients as being at low, medium, or high risk of recurrence.