Background Since the recurrence rate of papillary thyroid carcinoma is as high as 30% after surgery, and there are few studies on the prognosis of moderate and high-risk PTC patients after 131I treatment.
Objective To investigate the factors associated with recurrence of papillary thyroid carcinoma (PTC) after radioiodine therapy.
Methods Clinical data about middle-high-risk PTC patients who underwent thyroid surgery for the first time and postoperative radioiodine therapy in the First Medical Center of Chinese PLA General Hospital from January 2015 to December 2016 were retrospectively analyzed to explore the risk factors related to recurrence.
Results A total of 305 patients were included, including 96 males and 209 females, aged from 15 to 81 (41.7±11.9) years, 223 cases (73.1%) at intermediate risk, 82 cases (26.9%) at high risk, 292 cases (95.7%) at stage I-Ⅱ, 13 cases (4.3%) at stage Ⅲ-Ⅳ. The follow-up time span was 3-85 months, with median follow-up time of 70 months, and 44 (14.4%) cases had recurrence. Univariate and multivariate Cox regression analysis showed that age ≥ 55 years (HR=2.774, 95% CI: 1.420-5.418, P=0.003), multifocal carcinoma (HR=2.464, 95% CI: 1.302-4.663, P=0.006), extra-gland invasion (HR=3.455, 95% CI: 1.589-7.510, P=0.002) and lateral lymph node metastasis (LLNM)(HR=13.446, 95% CI: 5.524-32.733, P<0.001) were independent risk factors for postoperative recurrence.
Conclusion Attention should be paid to early standardized treatment of PTC. Age ≥55 years, multifocal carcinoma, extra-glandular invasion and LLNM are closely related to recurrence. Postoperative attention should be paid to patients with these features.
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