Recurrent papillary thyroid cancer: analysis of prognostic factors including the histological variant

Objective: To analyse the factors that influence the development of recurrent papillary thyroid carcinoma, including the histological variant. Design: Retrospective study. Setting: Teaching hospital, Spain. Subjects: 200 patients who had papillary thyroid cancers resected between 1970 and 1995. Main outcome measures: Prognostic factors and disease‐free interval assessed by univariate and multivariate analysis. Results: All patients were followed up for a mean of 9 years (range 4–29). 54 patients presented with recurrent disease (27%) of whom 19 (35%) died of their disease. 5‐year, 10‐year, and 15‐year survival for those with recurrent disease were 75%, 68%, and 60%, respectively. The corresponding figures for the whole series were 93%, 90%, and 84%. The significant variables on multivariate analysis were completeness of resection (p = 0.002), extrathyroid involvement (p < 0.002), presence of lymph node metastases (p = 0.002), and histological variant of the carcinoma (p < 0.001). Conclusion: Using these risk factors it is possible to draw up a prognostic index and classify patients as being at low, medium, or high risk of recurrence. Copyright © 2001 Taylor and Francis Ltd.