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KMID : 0361020210640010019
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Korean Journal of Otolaryngology - Head and Neck Surgery
2021 Volume.64 No. 1 p.19 ~ p.25
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Characteristics and Prognostic Factors of Recurrence after Hemithyroidectomy in Patients with Papillary Thyroid Microcarcinoma
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Lee Ji-Hoon
Lee Gil-Joon
Sohn Jin-Ho
Ahn Dong-Bin
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Abstract
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Background and Objectives: The incidence of papillary thyroid microcarcinoma (PTMC) continues to increase worldwide. However, there is a lack of a comprehensive understanding of recurrence after hemithyroidectomy in patients with PTMC. We aimed to evaluate the characteristics and risk factors of recurrence after hemithyroidectomy in patients with PTMC.
Subjects and Method: We included 527 patients with PTMC who underwent hemithyroidectomy between 2009 and 2017.
Results: At a mean follow-up of 76.4 months after hemithyroidectomy, recurrence occurred in 4.2% (22/527) of the patients. The times of recurrence were <12, 12-24, 24-36, 36-48, 48-60, and >60 months after initial surgery in 1 (4.5%), 6 (27.3%), 5 (22.7%), 4 (18.2%), 4 (18.2%), and 2 (9.1%) patient(s), respectively. The most common recurrence site was the contralateral remaining thyroid lobe. In univariate analyses, only multifocality was demonstrated to be associated with an increased risk of recurrence [hazard ratio (HR), 2.834; confidence interval (CI), 1.044-7.693; p=0.041). In multivariate analyses, multifocality (HR, 2.982; CI, 1.091-8.155; p=0.033) and central lymph node metastasis (HR, 9.649; CI, 1.238-75.217; p=0.030) were demonstrated to be associated with an increased risk of recurrence.
Conclusion: The follow-up after hemithyroidectomy for PTMC should focus on the postoperative 1?5-year period with meticulous inspection of the remaining thyroid lobe, particularly in patients with multifocality or central lymph node metastasis.
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KEYWORD
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Papillary thyroid cacer, Prognosis, Recurrence, Risk factors, Thyroidectomy
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