The biology of papillary thyroid carcinoma (PTC) in young patients is poorly understood, and there are conflicting data regarding the recurrence for younger patients compared to older patients. We retrospectively analyzed 2348 clinically node-negative (cN0) PTC patients who underwent a thyroid lobectomy between 2008 and 2017. Young age was defined as less than 35 years old. The clinicopathological characteristics and oncologic outcomes of the young age group were compared to those of the older age group. The number of young age cN0 PTC patients accounted for 20.7% of the enrolled patients, and 24.2% were upstaged into pathologic N1a. The young age group had a significantly larger proportion of females, endoscopic/robotic thyroid lobectomies, stage N1a, and larger tumor sizes. Post-lobectomy recurrences were significantly higher in the young age group. In the Cox analysis, young age, large tumor size, and stage N1a were significant risk factors. The multivariate analysis reveals that young age and stage N1a are significant risk factors. Conversely, minimally invasive or robot-endoscopic thyroidectomies were not risk factors for post-lobectomy recurrence compared to conventional thyroidectomies. While young patients with a stage N1a had a significant risk factor for post-lobectomy recurrence, endoscopic/robotic thyroidectomy was as feasible and safe as conventional thyroidectomies in the median seven-year oncologic follow-up. Further high-quality studies are needed to elucidate the relationship between age and the risk of post-lobectomy recurrence.
年轻患者中甲状腺乳头状癌（PTC）的生物学特性尚不明确，且关于年轻患者与老年患者复发风险的对比数据存在矛盾。本研究回顾性分析了2008年至2017年间接受甲状腺叶切除术的2348例临床淋巴结阴性（cN0）PTC患者，将年轻患者定义为年龄小于35岁。通过对比年轻组与年长组的临床病理特征及肿瘤学结局发现：年轻cN0 PTC患者占纳入患者总数的20.7%，其中24.2%术后病理分期升级为N1a期。年轻组女性比例、内镜/机器人甲状腺叶切除术比例、N1a分期比例及肿瘤体积均显著更高。术后复发率在年轻组中显著升高，Cox分析显示年轻、肿瘤体积大及N1a分期是显著危险因素，多变量分析进一步证实年轻与N1a分期是独立危险因素。值得注意的是，与传统甲状腺切除术相比，微创或机器人内镜甲状腺切除术并未增加术后复发风险。在中位七年的肿瘤学随访中，虽然N1a分期的年轻患者术后复发风险显著升高，但内镜/机器人甲状腺切除术与传统术式同样安全可行。未来仍需高质量研究进一步阐明年龄与甲状腺叶切除术后复发风险的关系。
肿瘤(癌症)患者之家