Previous studies suggested that the multifocality of papillary thyroid carcinoma (PTC) would increase the risk of recurrence; however, the impact of its bilaterality remains unclear. Between 2011 and 2018, 1258 patients with PTC underwent total thyroidectomy at Ewha University Medical Center. The 5-year recurrence-free survival rate was 95.7% in patients with bilateral PTC, while those with unilateral multifocal PTC and a unifocal tumor showed a 5-year event-free survival rate of 97.0% and 97.8%, respectively (p= 0.004). A multivariable Cox proportional hazards model indicated that bilaterality (HR 2.550, 95% CI 1.354–4.800), male sex (HR 2.010, 95% CI 1.007–4.013), and tumor size (HR 1.748, 95% CI 1.316–2.323) were associated with recurrence, although unilateral multifocality did not increase the risk of recurrence (HR 1.211, 95% CI 0.348–4.213). In conclusion, bilaterality was associated with aggressive features, including tumor size and microscopic ETE. Moreover, bilaterality was an independent predictor of recurrence in patients with PTC. Patients with bilateral PTC might require careful treatment and follow-up approaches.
既往研究表明，甲状腺乳头状癌（PTC）的多灶性会增加复发风险，但其双侧性的影响尚不明确。2011年至2018年间，梨花大学医学中心共有1258例PTC患者接受了全甲状腺切除术。双侧PTC患者的5年无复发生存率为95.7%，而单侧多灶性PTC和单灶性肿瘤患者的5年无事件生存率分别为97.0%和97.8%（p=0.004）。多变量Cox比例风险模型显示，双侧性（HR 2.550，95% CI 1.354–4.800）、男性（HR 2.010，95% CI 1.007–4.013）和肿瘤大小（HR 1.748，95% CI 1.316–2.323）与复发相关，而单侧多灶性并未增加复发风险（HR 1.211，95% CI 0.348–4.213）。综上所述，双侧性与侵袭性特征（包括肿瘤大小和显微镜下甲状腺外侵犯）相关。此外，双侧性是PTC患者复发的独立预测因素。双侧PTC患者可能需要更谨慎的治疗和随访策略。
Bilaterality as a Risk Factor for Recurrence in Papillary Thyroid Carcinoma
肿瘤(癌症)患者之家