title: Prognosis after reoperation for local recurrence of papillary thyroid carcinoma.
abstract: OBJECTIVE
  To investigate the factors associated with a favorable prognosis after reoperation for local recurrent papillary thyroid carcinoma (PTC), we reviewed 45 patients who underwent surgery for first local recurrence of PTC.
  
  
  METHODS
  We divided the patients into two groups. Group A (n = 28) had no second recurrence, and group B (n = 17) had second local recurrence after surgery for recurrence.
  
  
  RESULTS
  The mean follow-up period after reoperation was 56.9 months. The mean age at the time of reoperation in group A was significantly lower than that in group B, at 48.1 years versus 62.3 years, respectively (P = 0.0007). The mean age at the time of the initial operation in group A was also significantly lower than that in group B, at 40.1 years versus 55.1 years, respectively (P = 0.0006). Patients with recurrent tumors only outside the area dissected at the initial operation (n = 27) had a better outcome than those with recurrence within the dissected area (n = 18; P = 0.0127). Patients who underwent systematic partial or modified neck dissection (n = 36) had a better outcome than those who underwent only simple local resection (n = 9; P = 0.0169).
  
  
  CONCLUSIONS
  For local recurrent PTC, systematic neck dissection is recommended over local resection of recurrent tumors.
authors.affiliation: Department of Surgery, Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Uruno
authors.forename: Akira
authors.initials: A
authors.lastname: Miyauchi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shimizu
authors.forename: Keiichi
authors.initials: K
authors.lastname: Nakano
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Takamura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ito
authors.forename: Akihiro
authors.initials: A
authors.lastname: Miya
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Yokozawa
authors.forename: Fumio
authors.initials: F
authors.lastname: Matsuzuka
authors.forename: Kanji
authors.initials: K
authors.lastname: Kuma
mesh_terms: D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011336:Probability; D011379:Prognosis; D012086:Reoperation; D018570:Risk Assessment; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome