RISK-FACTORS IN PAPILLARY THYROID-CARCINO MA

270 patients with papillary thyroid carcinoma were retrospectively ana lyzed. The mean age at initial diagnosis was 43.5 years. 74% of the pa tients were females. 15 patients (6%) had residual tumor after initial surgery and 61 patients (24%) showed recurrent disease. The recurrenc e was discovered clinically, radiologically and by increasing thyreogl obulin levels in 72%, 23% and 5% of the patients, respectively. Recurr ent disease was located in the tumor bed, locally and metastatic and o nly metastatic in 61%, 23% and 16% of the patients, respectively. Afte r a mean follow-up of 9.4 years (range 3-20 years) the overall mortali ty was 13%. 6% of the patients died from tumor, 3% with tumor and 4% w ithout tumor. 46% of patients with residual tumor died from tumor prog ression, in contrast to 18% of patients with early recurrence (<5 year s) and 6% of patients with late recurrence (>5 years). We conclude tha t papillary thyroid carcinoma has a low mortality (6%) even in an ende mic area. Patients with residual tumor after initial surgery and patie nts with early recurrence have an increased cancer mortality.