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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

이지훈, 이길준, 손진호, 안동빈,
소속 상세정보
이지훈 ( Lee Ji-Hoon ) - Kyungpook National University School of Medicine Department of Otolaryngology-Head and Neck Surgery
이길준 ( Lee Gil-Joon ) - Kyungpook National University School of Medicine Department of Otolaryngology-Head and Neck Surgery
손진호 ( Sohn Jin-Ho ) - Kyungpook National University School of Medicine Department of Otolaryngology-Head and Neck Surgery
안동빈 ( Ahn Dong-Bin ) - Kyungpook National University School of Medicine Department of Otolaryngology-Head and Neck Surgery

Abstract


Background and Objectives: The incidence of papillary thyroid microcarcinoma (PTMC) continues to increase worldwide. However, there is a lack of a comprehensive understanding of recurrence after hemithyroidectomy in patients with PTMC. We aimed to evaluate the characteristics and risk factors of recurrence after hemithyroidectomy in patients with PTMC.

Subjects and Method: We included 527 patients with PTMC who underwent hemithyroidectomy between 2009 and 2017.

Results: At a mean follow-up of 76.4 months after hemithyroidectomy, recurrence occurred in 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 contralateral remaining thyroid lobe. In univariate analyses, only multifocality was demonstrated to be associated with 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 postoperative 1?5-year period with meticulous inspection of the remaining thyroid lobe, particularly in patients with multifocality or central lymph node metastasis.

키워드

Papillary thyroid cacer; Prognosis; Recurrence; Risk factors; Thyroidectomy

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