Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
Sci Rep. 2022 Aug 8;12(1):13548. doi: 10.1038/s41598-022-17979-2.
The extent of surgery among patients with T2 papillary thyroid carcinoma (PTC) remains controversial. Thus, we herein aimed to evaluate the risk factors for recurrence, particularly based on the extent of surgery, among patients with T2 PTC at a single tertiary institution. We assessed 251 patients who underwent thyroid surgery for T2 PTC from January 2009 to December 2014 at Seoul St. Mary's Hospital (Seoul, Korea). The mean follow-up duration was 100.7 months. Eleven (4.4%) patients had recurrence. The recurrence rates did not significantly differ in terms of the extent of surgery (p = 0.868). Patients with a high lymph node ratio (LNR) had a significantly higher recurrence rate than those with a low LNR (p < 0.001). According to a recurrence pattern analysis, five of six patients in the lobectomy group had recurrence in the ipsilateral lateral compartment. A multivariate analysis revealed that a high LNR was a significant risk factor for recurrence (hazard ratio: 11.025, p = 0.002). Our results suggest that patients without clinical evidence of any lymph node metastases and those with limited lesions in the thyroid gland can undergo lobectomy and LNR can serve as an independent risk factor for predicting recurrence in T2 PTC.
T2 型甲状腺乳头状癌（PTC）患者的手术范围仍存在争议。因此，我们旨在评估单中心 251 例 T2 PTC 患者的复发风险因素，尤其是基于手术范围。这些患者于 2009 年 1 月至 2014 年 12 月在首尔圣玛丽医院（韩国首尔）接受了甲状腺手术。平均随访时间为 100.7 个月。11 例（4.4%）患者出现复发。手术范围不同，复发率无显著差异（p=0.868）。高淋巴结比（LNR）患者的复发率明显高于低 LNR 患者（p<0.001）。根据复发模式分析，在甲状腺叶切除术组的 6 例患者中，有 5 例在同侧外侧隔复发。多因素分析显示，高 LNR 是复发的显著危险因素（风险比：11.025，p=0.002）。我们的结果表明，无任何临床淋巴结转移证据且甲状腺内病变有限的患者可接受甲状腺叶切除术，LNR 可作为预测 T2 PTC 复发的独立危险因素。
