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갑상선 미세유두암 환자에서 반갑상선 절제술 후 재발의 특징 및 예후 인자

Characteristics and Prognostic Factors of Recurrence after Hemithyroidectomy in Patients with Papillary Thyroid Microcarcinoma

손진호|이길준|안동빈|이지훈
대한이비인후과학회 (Korean Society of Otorhinolaryngology-Head and Neck Surgery)|2021.01|대한이비인후과학회지 두경부외과학 (Korean Journal of Otorhinolaryngology-Head and Neck Surgery)|제64권 제1호|pp. 19-25|DOI https://doi.org/10.3342/kjorl-hns.2019.00892

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참고문헌

키워드

Risk factorsRecurrencePrognosisThyroidectomy.Papillary thyroid cacer
주제분류이비인후과학

초록

Background and Objectives The incidence of papillary thyroid microcarcinoma (PTMC)continues to increase worldwide. However, there is a lack of a comprehensive understandingof recurrence after hemithyroidectomy in patients with PTMC. We aimed to evaluate the characteristicsand risk factors of recurrence after hemithyroidectomy in patients with PTMC. Subjects and Method We included 527 patients with PTMC who underwent hemithyroidectomybetween 2009 and 2017. Results At a mean follow-up of 76.4 months after hemithyroidectomy, recurrence occurredin 4.2% (22/527) of the patients. The times of recurrence were <12, 12-24, 24-36, 36-48, 48-60, and >60 months after initial surgery in 1 (4.5%), 6 (27.3%), 5 (22.7%), 4 (18.2%), 4 (18.2%),and 2 (9.1%) patient(s), respectively. The most common recurrence site was the contralateralremaining thyroid lobe. In univariate analyses, only multifocality was demonstrated to be associatedwith an increased risk of recurrence [hazard ratio (HR), 2.834; confidence interval(CI), 1.044-7.693; p=0.041). In multivariate analyses, multifocality (HR, 2.982; CI, 1.091-8.155; p=0.033) and central lymph node metastasis (HR, 9.649; CI, 1.238-75.217; p=0.030)were demonstrated to be associated with an increased risk of recurrence. Conclusion The follow-up after hemithyroidectomy for PTMC should focus on the postoperative1–5-year period with meticulous inspection of the remaining thyroid lobe, particularlyin patients with multifocality or central lymph node metastasis.

Abstract

Background and Objectives The incidence of papillary thyroid microcarcinoma (PTMC)continues to increase worldwide. However, there is a lack of a comprehensive understandingof recurrence after hemithyroidectomy in patients with PTMC. We aimed to evaluate the characteristicsand risk factors of recurrence after hemithyroidectomy in patients with PTMC. Subjects and Method We included 527 patients with PTMC who underwent hemithyroidectomybetween 2009 and 2017. Results At a mean follow-up of 76.4 months after hemithyroidectomy, recurrence occurredin 4.2% (22/527) of the patients. The times of recurrence were <12, 12-24, 24-36, 36-48, 48-60, and >60 months after initial surgery in 1 (4.5%), 6 (27.3%), 5 (22.7%), 4 (18.2%), 4 (18.2%),and 2 (9.1%) patient(s), respectively. The most common recurrence site was the contralateralremaining thyroid lobe. In univariate analyses, only multifocality was demonstrated to be associatedwith an increased risk of recurrence [hazard ratio (HR), 2.834; confidence interval(CI), 1.044-7.693; p=0.041). In multivariate analyses, multifocality (HR, 2.982; CI, 1.091-8.155; p=0.033) and central lymph node metastasis (HR, 9.649; CI, 1.238-75.217; p=0.030)were demonstrated to be associated with an increased risk of recurrence. Conclusion The follow-up after hemithyroidectomy for PTMC should focus on the postoperative1–5-year period with meticulous inspection of the remaining thyroid lobe, particularlyin patients with multifocality or central lymph node metastasis.

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