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Lobectomy may increase recurrence in small papillary thyroid cancer
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Adults with small papillary thyroid cancer who underwent lobectomy or have tumor sizes of at least 1.8 cm, two or more metastatic lymph nodes or bilateral tumors have an increased risk for long-term recurrence, study data show.
Ka Hee Yi, MD, PhD, of the department of internal medicine, Seoul National University College of Medicine in Korea, and colleagues conducted a nationwide, retrospective, multicenter study including 3,282 adults (mean age, 47 years) with papillary thyroid cancer of 2 cm or smaller from nine high-volume hospitals in Korea to characterize high-risk factors for long-term recurrence. Follow-up was a mean of 5.8 years.
Total, near total or subtotal thyroidectomies were performed in 86% of participants, and 77.4% in the total thyroidectomy group underwent radioactive iodine ablation therapy.
Participants were divided into two groups based on tumor size from 0.7 cm to 1.9 cm with a 0.1-cm interval. For predicting the risk for recurrence, the optimal tumor size cutoff of 1.8 cm was used.
Disease recurred in 190 participants during follow-up. The 5-year recurrence rate was 4.5% and the 10-year recurrence rate was 8.9%. The 5- and 10-year recurrence rates were greater in the lobectomy group than in the total thyroidectomy group. The most common site of recurrence was lymph nodes in the neck (64%), followed by the thyroid bed and lungs.
Recurrence was significantly associated with age up to 45 years (HR = 0.74; 95% CI, 0.55-0.98), tumor size of at least 1.8 cm (HR = 2.39; 95% CI, 1.75-3.33), lymph node metastasis and lobectomy (HR = 1.71; 95% CI, 1.19-2.45). – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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