title: Risk factors influencing the recurrence of papillary thyroid carcinoma: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the risk factors influencing the recurrence of papillary thyroid carcinoma.
  
  
  METHODS
  This meta-analysis used MEDLINE (PubMed), EMBASE and CNKI including all cohort studies reporting the risk factors influencing the recurrence after the initial operation on PTC up to February 23, 2014. Software RevMan 5.2 was used for meta-analysis.
  
  
  RESULTS
  Thirteen studies with a total of 7048 patients were included in our meta-analysis. Of all variables, gender, extrathyroid extension, LNM, tumor size, distance metastasis, thyroid surgery types and 131-I given or not were significantly correlated with recurrence, While overall recurrence was similar between the group of ≤ 45 years and > 45 years, multifolicality and solitary. However, when stratified the participants by study location (ie, Asian including China, Korea, Japan, Western country including America, France, Italy, Australia), a statistically significant summary odds ratio for age were found in Western country but none in Asian.
  
  
  CONCLUSIONS
  The risk factors influencing recurrence includes male, extrathyroid extension, LNM, tumor size more than 2 cm, distance metastasis and subtotal thyroidectomy. However, selection of operation mode should be based on not only the recurrence but the comprehensive consideration of the clinical features.
authors.affiliation: Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center Shanghai 200032, China ; Department of Oncology, Fudan University Shanghai Medical College Shanghai 200032, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Guo
authors.affiliation: Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center Shanghai 200032, China ; Department of Oncology, Fudan University Shanghai Medical College Shanghai 200032, China.
authors.forename: Zhuoying
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000328:Adult; D000367:Age Factors; D002277:Carcinoma / Q000453:epidemiology / Q000601:surgery*; D002291:Carcinoma, Papillary; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Papillary thyroid carcinoma; recurrence; risk factors