title: Risk factors for recurrence after therapeutic lateral neck dissection for primary papillary thyroid cancer.
abstract: BACKGROUND
  Lateral lymph node metastasis is an important prognostic factor and is predictive of tumor recurrence and cause-specific survival in patients with papillary thyroid cancer (PTC). However, the factors predicting recurrence and clinical outcomes after therapeutic lateral neck dissection are not well established. The aims of this study were to evaluate the incidence, pattern, and factors predictive of PTC recurrence after therapeutic lateral neck dissection.
  
  
  METHODS
  The records of 126 consecutive patients who underwent total thyroidectomy with therapeutic lateral neck dissection for primary PTC at the National Cancer Center were retrospectively reviewed. The factors predictive of recurrence were determined using both univariate and multivariate analyses considering several clinicopathologic variables.
  
  
  RESULTS
  The median follow-up period was 61.2 months, during which 22 patients (17.5 %) experienced recurrence with 1 death (0.8 %) due to disease. Locoregional recurrence and distant metastasis were found in 20 cases (15.9 %) and 2 cases (1.6 %), respectively. Male gender, aggressive histology, number of lymph node metastases, initial level of T4-off Tg per ng/mL, and ATA risk categories (high risk) were independent risk factors for recurrence. Of note, initial T4-off Tg levels greater than 4.2 ng/mL showed highest sensitivity and specificity in predicting recurrence.
  
  
  CONCLUSIONS
  These results provide useful information regarding the clinical outcomes after therapeutic lateral neck dissection for primary PTC and can be used to identify at-risk patients who need aggressive treatment and intensive surveillance for postoperative recurrence.
authors: Department of Surgery, Seoul National University Hospital & College of Medicine, Seoul, Korea.
authors: Su-Jin
authors: SJ
authors: Kim
authors: Seog Yun
authors: SY
authors: Park
authors: You Jin
authors: YJ
authors: Lee
authors: Eun Kyung
authors: EK
authors: Lee
authors: Seok-Ki
authors: SK
authors: Kim
authors: Tae Hyun
authors: TH
authors: Kim
authors: Yu-Seog
authors: YS
authors: Jung
authors: Junsun
authors: J
authors: Ryu
authors: Jun Pyo
authors: JP
authors: Myong
authors: Ki-Wook
authors: KW
authors: Chung
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001323:Autoantibodies / Q000097:blood; D002291:Carcinoma, Papillary / Q000097:blood / Q000556:secondary* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000473:pathology*; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013954:Thyroglobulin / Q000097:blood; D013964:Thyroid Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D047368:Tumor Burden
chemical_list: D001323:Autoantibodies; C006606:anti-thyroglobulin; D013972:Thyrotropin; D013954:Thyroglobulin; D013974:Thyroxine