Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
Surgical Oncology Division, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
Acta Otorhinolaryngol Ital. 2021 Jun;41(3):236-242. doi: 10.14639/0392-100X-N1412.
The incidence of papillary thyroid carcinoma (PTC) has increased in recent years and its treatment remains controversial. The objective of this study is to identify clinicopathological predictive factors of tumour recurrence.
We retrospectively analysed 4,085 patients who underwent thyroidectomy for PTC from 1996 to 2015. Patients were stratified according to American Thyroid Association (ATA) risk categories and clinicopathological features were evaluated to identify independent factors for recurrence.
After a mean follow-up of 58.7 (range 3-256.5) months, tumour recurrence was diagnosed in 176 (4.3%) patients, mostly in lymph nodes. Distant metastasis occurred in 18 patients (0.4%). There were 3 (0.1%) cancer-related deaths. Multivariate analysis showed that tumour size >10 mm, multifocality, extrathyroidal extension and lymph node metastasis (all, < 0.001) were independent risk factors for recurrence. Further, recurrence was identified in 1.6% of the ATA low-risk, 7.4% of the intermediate-risk and 22.7% of the high-risk patients ( < 0.001).
In PTC patients, tumour size >10 mm, multifocality, extrathyroidal extension and presence of lymph node metastasis as well as the ATA recurrence staging system effectively predict recurrence.
近年来，甲状腺乳头状癌（PTC）的发病率有所增加，其治疗仍存在争议。本研究旨在确定肿瘤复发的临床病理预测因素。
我们回顾性分析了 1996 年至 2015 年间接受甲状腺切除术治疗的 4085 例 PTC 患者。根据美国甲状腺协会（ATA）风险类别对患者进行分层，并评估临床病理特征，以确定复发的独立因素。
平均随访 58.7（范围 3-256.5）个月后，176 例（4.3%）患者诊断为肿瘤复发，主要发生在淋巴结。18 例患者发生远处转移（0.4%）。有 3 例（0.1%）与癌症相关的死亡。多因素分析显示，肿瘤大小>10mm、多灶性、甲状腺外侵犯和淋巴结转移（均<0.001）是复发的独立危险因素。此外，ATA 低危、中危和高危患者的复发率分别为 1.6%、7.4%和 22.7%（<0.001）。
在 PTC 患者中，肿瘤大小>10mm、多灶性、甲状腺外侵犯和淋巴结转移以及 ATA 复发分期系统可有效预测复发。
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