Characteristics and Prognostic Factors of Recurrence after Hemithyroidectomy in Patients with Papillary Thyroid Microcarcinoma
10.3342/kjorl-hns.2019.00892
- Author:
Jihoon LEE
1
;
Gil Joon LEE
;
Jin Ho SOHN
;
Dongbin AHN
Author Information
1. Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
- Publication Type:Original Article
- From:Korean Journal of Otolaryngology - Head and Neck Surgery
2021;64(1):19-25
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
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.
