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Risk factors for lymph node recurrence in papillary thyroid carcinoma:experience with 2,000 patients operated on by a single surgeon.

Celso UM Friguglietti, Chin S. Lin

Background: This study determined the predictive factors affecting lymph node recurrence in a large cohort with papillary thyroid carcinoma operated on by a single surgeon.

Methods: Retrospective, cross-sectional study including 2,112 patients with papillary thyroid carcinoma undergoing total thyroidectomy and therapeutic lymph node dissection.

Results: During a mean follow-up of 41 months, 63 patients experienced lymph node recurrence. On multivariate analysis, lymph node recurrence was associated with lymph node metastases (odds ratio [OR] 19.205 for metastasis to a single lymph node, p<0.001), use of radioiodine therapy (OR 3.344, p=0.012), and extrathyroidal extension (OR 2.167, p=0.011). The presence of two positive lymph nodes (OR 18.9, p<0.001) and a primary tumor size of 1.15 cm were predictors of lymph node recurrence.

Conclusions: In a large cohort with papillary thyroid carcinoma, the presence of two positive lymph nodes and a primary tumor size of 1.15 cm predicted lymph node recurrence.