Abstract
papillary thyroid carcinoma is a tumor with good prognosis. However, some patients treated present neck recurrence. to evaluate the risk factors for neck recurrence. a retrospective study enrolled 89 patients (68 women and 21 men) diagnosed with papillary carcinoma who underwent total thyroidectomy. In 21 patients, neck dissection was performed and 62 patients underwent radioiodinetherapy. Twelve patients relapsed with metastasis in this period with an average of 3.6 years. out of 89 patients, 76.4% were female. Relapse occurred in nine (13.23%) women and three (14.28%) men. The average age of the patients was 44 years in the control group and in patients with relapsed. Eighteen patients (23.37%) in the control group and eight (64.28%) who relapsed had positive lymph nodes at initial diagnosis. The tumor size was significantly larger in the group of patients with cervical recurrence (3.3cm vs. 1.6cm - p=0.008, Student t test), whereas the presence of metastatic lymph nodes at the moment of the first operation was also significant (p=0.004 -Fisher exact test). The tumor size was an independent risk factor for recurrence at the multivariate anaylsis (OR=2.4, IC95%:1.3-4.6 - p=0,007, logistic regression). there is an increase in the risk of lymph node recurrence during the follow up of 2.4 folds for each increase of 1cm in the longer nodule diameter.
Highlights
Thyroid cancer is the most common endocrine malignancy, the papillary carcinoma being the most common histologic type, comprising 85-95% of cases
The aim of this study was to evaluate risk factors for lateral regional recurrence in patients previously treated for papillary carcinoma of thyroid
The study was approved by the Ethics in Research Committee of the institution where it was carried out. This is a retrospective study in which we reviewed medical records from the period between 2000 and 2010, with 89 patients (68 women and 21 men) diagnosed with papillary carcinoma and treated at our service
Summary
Thyroid cancer is the most common endocrine malignancy, the papillary carcinoma being the most common histologic type, comprising 85-95% of cases. These are indolent biological behavior tumors, whose 10 year survival rates are greater s 90%1. The importance of regional lymph node disease may have been underestimated in the past, due to the good prognosis of these tumors. The observation of such metastases did not influence the rates of survival, not being considered a risk factor in most proposed systems[2,5]. The size of the lymph node metastasis in the lateral compartment is a significant risk factor for locoregional recurrence, distant metastasis and shorter survival[6]
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