Annals of Surgical Oncology

, Volume 22, Issue 11, pp 3543–3549 | Cite as

Factors Affecting the Locoregional Recurrence of Conventional Papillary Thyroid Carcinoma After Surgery: A Retrospective Analysis of 3381 Patients

  • Yong Joon Suh
  • Hyungju Kwon
  • Su-jin Kim
  • June Young Choi
  • Kyu Eun Lee
  • Young Joo Park
  • Do Joon Park
  • Yeo-Kyu Youn
Endocrine Tumors



Papillary thyroid carcinoma (PTC) does recur, despite its favorable long-term outcome. The incidence of thyroid cancer in South Korea increased during the 1990s, then increased rapidly after the turn of the century. In 2011, the rate of thyroid cancer diagnoses was 15 times that observed in 1993. The present study aimed to identify factors associated with the locoregional recurrence of recently increasing conventional PTC.


The records of 3381 patients with conventional PTC were reviewed for this retrospective cohort study. Between January 2004 and January 2012, these patients underwent ultrasonography, computed tomography, and preoperative and total thyroidectomy with central neck dissection. Disease recurrence was defined as structural evidence of disease following the remission period.


Median length of follow-up was 5.6 (range 2.1–10.1) years. Of 3381 patients, 75 (2.2 %) experienced recurrence. The univariate analysis suggested that locoregional recurrence was associated with tumor size, multifocality, extrathyroidal extension (ETE), lymph node metastasis, lymphatic invasion, vascular invasion, and positive surgical margin. However, multivariate analysis showed that only tumor size (p < 0.001), bilaterality (p < 0.001), gross ETE (p = 0.049), lymph node metastasis (p < 0.001), and vascular invasion (p = 0.013) were independently associated with locoregional recurrence.


Tumor size, bilaterality, gross ETE, lymph node metastasis, and vascular invasion were associated with locoregional recurrence. Evaluation of these prognostic factors appears to help identify patients who require close monitoring.


Thyroid Cancer Papillary Thyroid Carcinoma Total Thyroidectomy Locoregional Recurrence Follicular Thyroid Carcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



All statistical analyses were supported by the Medical Research Collaborating Center, Seoul National University and Seoul National University Hospital, Seoul, Korea. The authors are indebted to J. Patrick Barron (Professor Emeritus of Tokyo Medical University and Adjunct Professor of Seoul National University Bundang Hospital) for his editorial work.


Yong Joon Suh, Hyungju Kwon, Su-jin Kim, June Young Choi, Kyu Eun Lee, Young Joo Park, Do Joon Park, and Yeo-Kyu Youn declare no conflicts of interest and disclose no financial ties.

Supplementary material

10434_2015_4448_MOESM1_ESM.tif (39 kb)
Supplementary material 1 A flow diagram of the study design. PTC papillary thyroid carcinoma (TIFF 38 kb)
10434_2015_4448_MOESM2_ESM.tif (111 kb)
Supplementary material 2 The risk and rate of recurrence according to age. The relative hazard ratio (HR) in each decade was illustrated by the blue line. Gray shading indicates 95% confidence interval. (TIFF 111 kb)
10434_2015_4448_MOESM3_ESM.tif (36 kb)
Supplementary material 3 The positive lymph node number of 2 showed the highest accuracy, although the recurrence rate was significantly higher in the group with an initial ratio ≥0.3. A ROC curve with the number of 2 resulted in a sensitivity of 80.7% and a specificity of 79% (AUC=0.83, 95% confidence interval: 0.77-0.88, p<.001). ROC receiver operating characteristic curve, LN lymph node, AUC area under the curve (TIFF 35 kb)
10434_2015_4448_MOESM4_ESM.docx (16 kb)
Supplementary material 4 (DOCX 15 kb)


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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Yong Joon Suh
    • 1
    • 2
  • Hyungju Kwon
    • 1
    • 2
  • Su-jin Kim
    • 1
    • 2
  • June Young Choi
    • 2
    • 3
  • Kyu Eun Lee
    • 1
    • 2
  • Young Joo Park
    • 2
    • 4
  • Do Joon Park
    • 2
    • 4
  • Yeo-Kyu Youn
    • 1
    • 2
  1. 1.Department of SurgerySeoul National University Hospital and College of MedicineSeoulKorea
  2. 2.Cancer Research InstituteSeoul National University College of MedicineSeoulKorea
  3. 3.Department of SurgerySeoul National University Bundang HospitalGyeonggi-doKorea
  4. 4.Department of Internal MedicineSeoul National University Hospital and College of MedicineSeoulKorea

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