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

Objective: To analyse the factors that influence the development of recurre nt papillary thyroid carcinoma, including the histological variant. Design: Retrospective study. Setting: Teaching hospital, Spain. Subjects: 200 patients who had papillary thyroid cancers resected between 1 970 and 1995. Main outcome measures: Prognostic factors and disease-free interval assesse d 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 recurr ent 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), extrathyr oid 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 recur rence.