Publication:

Survival outcomes of locoregionally advanced papillary thyroid carcinoma

Background PTC carries an overall excellent prognosis. Most patients with PTC have small and asymptomatic disease. This raises the question whether overall rates overestimate the survival of those with advanced disease. We use our institutional data to report disease-free and overall survival of patients with locoregionally advanced PTC.

Methods A retrospective study of 92 patients who underwent a total thyroidectomy from 2002 to 2019 at a single institution. Features of locoregionally advanced disease were defined as extra thyroid extension, primary tumor size ≥4 cm, or cervical nodal involvement. These and additional clinical and histological features were analyzed for association with recurrence and disease-free survival.

Results Twenty-six patients had recurrence of disease. Patients with ETE, nonspecific cervical nodal involvement, or tumor size ≥4 cm had no significant increase in recurrence (p=0.2554, 0.1886, 0.2278, respectively). Patients with nodal metastasis to lateral neck compartment had a significant increase in recurrence (p=0.0434). 5-year overall survival was 95%.

Conclusion PTC has an excellent prognosis even in the presence of advanced locoregional disease. However, lateral neck nodal involvement is associated with higher rates of recurrence and may be an indicator for more aggressive management.