title: Clinicopathological features of recurrent papillary thyroid cancer.
abstract: BACKGROUND
  To investigate the clinicopathological features of recurrent papillary thyroid carcinoma (PTC).
  
  
  METHODS
  A retrospective analysis on clinical and pathological data of 34 patients with recurrent PTC was carried out. A total of 281 patients with non-recurrent PTC during the same time period were chosen as the control group.
  
  
  RESULTS
  Patients were divided into three groups according to the pathological subtype. The number of patients belonging to Groups 1, 2, and 3 were 28, 154, and 133, respectively. 78 patients underwent partial or whole thyroidectomy, 151 cases underwent thyroidectomy combining neck regional lymph node dissection, and 86 patients underwent thyroidectomy combining modified or radical neck dissection. Univariate analysis showed that PTC recurrence was associated with tumor size, extrathyroid invasion, initial surgery approach, lymph node metastasis, and pathological subtype (P < 0.05). Patient age, gender, complication with Hashimoto's thyroiditis, and multifocality were unrelated to PTC recurrence (P > 0.05). Multivariate analysis showed that initial surgery approach and pathological subtype perform important functions in PTC recurrence (P < 0.001). Initial surgery approach presented a negative correlation with PTC recurrence (β = -0.320, OR = 0.726). The pathological subtype was also related to PTC recurrence (β = 0.923, OR = 2.517).
  
  
  CONCLUSIONS
  PTC patients without neck dissection showed greater likelihood of postoperative recurrence. Patients with the tall cell, columnar cell, diffuse sclerosing, and oncocytic variants showed a higher propensity for PTC recurrence after operation compared with those who did not. Tumor volume, extrathyroid invasion, and multiple lymph node metastases at the time of initial operation were also significantly related to postoperative recurrence. Follow-up supervision must be enhanced after initial treatment to mitigate PTC recurrence in susceptible patients. Effective and standard treatments must be adopted immediately after the discovery of recurrence.
authors.affiliation: Department of Thyroid and Breast Surgery, General Hospital of Jinan Military Command, Jinan, 250031, China. zhujiansdu@126.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Pathology, Affiliated Hospital of Taishan Medical College, Taian, 271000, China. active1980@126.com.
authors.forename: Xinli
authors.initials: X
authors.lastname: Wang
authors.affiliation: Medical Administration Division, General Hospital of Jinan Military Command, Jinan, 250031, China. 15168856085@163.com.
authors.forename: Xiaoxuan
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Pathology, General Hospital of Jinan Military Command, 25 Shifan Road, Tianqiao District, Jinan, 250031, China. lipeifeng00@hotmail.com.
authors.forename: Peifeng
authors.initials: P
authors.lastname: Li
authors.affiliation: Department of Statistics, Taishan Medical College, Taian, 271000, China. 651318760@qq.com.
authors.forename: Haifeng
authors.initials: H
authors.lastname: Hou
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery*; D002291:Carcinoma, Papillary; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D037981:Neck Dissection / Q000009:adverse effects; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult