Clinical analysis of 109 cases of recurrent papillary thyroid carcinoma

Abstract

Objective: To explore the factors related to recurrence of PTC (papillary thyroid carcinoma) and the sites of recurrence, in order to seek for the proper treatment of these cases. Methods: The clinical and follow-up data of 109 cases of recurrent PTC in Tianjin Medical University Cancer Hospital from January 2008 to January 2012 were analyzed retrospec­tively, and 350 cases of PTC without recurrence in the same period were also collected as the controls. The univariate and multivariate analyses were performed to find out the recurrence-related factors. Results: The univariate analysis revealed that initial operative approach, TNM stage and pathological subtype were associated with recurrence (P 0.05). Multivariate analysis indicated that initial operative approach and pathological subtype were the dependent factors for recurrence (P < 0.05). Of 109 cases, 20 (18.3%) were confirmed as residual carcinoma by pathology. The involved sites of recurrence included regions of lymph nodes (34 in group Ⅱ, 54 in group Ⅲ, 58 in group Ⅳ, 12 in group Ⅴ, 68 in group Ⅵ), soft tissues (5 in group Ⅱ, 6 in group Ⅲ, 9 in group Ⅳ, 0 in group Ⅴ, 8 in group Ⅵ), muscles (2 in anterior cervical muscle, 1 in extrinsic laryngeal muscle, and 0 in sternocleidomastoid), parathyroid (n = 1), laryngeal recurrent nerve (n = 3), esophagus (n = 1) and trachea (n = 2). Five cases developed pulmonary metastasis, and 1 case developed liver and bone metastases. Conclusion: For the PTC patients who have the possibility of recurrence, the reinforced postoperative follow-up should be required. Furthermore, regular reexamination is also needed for possible recurrent regions. Once the recurrence occurres, active and standardized therapy is suggested for PTC. DOI:10.3781/j.issn.1000-7431.2013.08.012