Recurrence in patients with clinically early-stage papillary thyroid carcinoma according to tumor size and surgical extent

BACKGROUND: To investigate whether post-treatment recurrence differs by tumor size or surgical extent in clinically early-stage papillary thyroid carcinoma (PTC) patients. METHODS: A total of 1,041 surgical patients with PTC 4 cm or less and no clinical evidence of metastases to regional or distant sites were included. Cox proportional hazard models were used to identify the clinicopathological variables predictive of post-treatment recurrence. RESULTS: Central nodal involvement was found in 313 (34.1%) of 918 patients who underwent prophylactic central lymph node dissection. For the median follow-up of 83 months, 25 (2.4%) of 1,041 patients had a regional recurrence and 12 (1.2%) patients died of other causes. Male gender, tumor size, extranodal extension, and positive resection margin remained independent variables predictive of recurrence by multivariate analysis (P < .05 each). There was no significant impact of age (<45 vs >= 45 years, P = .944) or surgical extent (unilateral vs bilateral thyroidectomy, P = .776) on recurrence. CONCLUSIONS: Tumor size in patients with PTC of 4 cm or less is an important predictive factor for post-treatment recurrence. (C) 2016 Elsevier Inc. All rights reserved.