Objective: To analyse the factors that influence the development of recurrent papillary thyroid carcinoma, including the histological variant.
Design: Retrospective study.
Setting: Teaching hospital, Spain.
Subjects: 200 patients who had papillary thyroid cancers resected between 1970 and 1995.
Main outcome measures: Prognostic factors and disease-free interval assessed 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 recurrent 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), extrathyroid 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 recurrence.