Session: SAT 270-310-Thyroid Neoplasia (posters)
Poster Board SAT 296
Objective: The aim of the study was to evaluate the risk factors for recurrence in patients with PTC ≤2 cm (T1).
Design and Patients: We conducted a retrospective, nationwide multicenter study including 3282 patients with papillary thyroid tumors sized ≤2 cm (T1) from 9 high volume hospitals in Korea. The Kaplan-Meier analysis was used to estimate disease-free survivial, and the Cox proportional hazards regression model was used to analyze the risk factors for recurrence. Maximally selected chi-square method was used to find best cutoff points of tumor size and lymph node ratio to predict the recurrence.
Setting: The study was performed at 9 hospitals in Korea.
Results: Lymph node metastasis (N1a; HR, 4.15; 95% CI, 2.72-6.31; N1b; HR, 6.55; 95% CI, 3.98-10.77; P<0.001), lobectomy (HR, 2.93; 95% CI, 1.75-4.88; P<0.001) and tumor size >1cm (HR, 1.82; 95% CI, 1.26-2.64; P=0.002) were independent risk factors for recurrence in all PTC patients. In patients with total thyroidectomy, bilaterality (HR, 2.11; 95% CI, 1.18-3.78; P=0.012) was associated with more frequent disease recurrence, while radioactive iodine ablation was not related to less frequent disease recurrence. Size at 1.7cm was the most appropriate cut-off value capable of dividing PTC patients into two subgroups by recurrence distributions (5 year recurrence rate; 3.7% vs.9.4%). Lymph node ratio at 41% was optimal cutpoint to classify PTC patients with central neck dissection predicting the risk of recurrence (5 year recurrence rate; 1.2% vs. 10.9%).
Conclusion: Total thyroidectomy is recommended for small PTC patients to reduce recurrence.
Nothing to Disclose: YH, JMK, YJP, DJP, YSC, KDL, EKL, YJL, SYS, SWK, JHC, DJL, MHK, MJK, YSJ, MS, SSK, JRH, JHJ, KHY
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