Factors predictive of papillary thyroid cancer (PTC)‎ recurrence post total thyroidectomy and radioiodine ablation : a single-center experience in the Jordanian Royal Medical services

Abstract EN

Aim: to assess the factors predictive of PTC recurrence after total thyroidectomy and radioiodine ablation using a retrospective analysis of patients treated for thyroid cancer by the Jordanian Royal Medical Services (JRMS).

Methods: 243 patients (56 men and 186 women) were included in the study (at King Hussein Medical Center) between January 2009-December 2017 with a mean age of 40 years.

All patients had papillary thyroid cancer.

Fifty-eight percent (58%) underwent a one-stage total thyroidectomy, and 42% underwent a two-stage thyroidectomy and all patients received I131 Radio-Iodine ablation.

Univariate regression analyses were used to study factors that may influence the risk of recurrent disease.

Results: There was no statistically significant difference for sex, initial thyroid surgical management, vascular invasion, positive surgical margin, or the dose of I131 Radio-Iodine ablation dose.

Tumour recurrence was found in 27% of patients younger than 40 years old at the time of diagnosis, which was found to be significant (P=0.009).

It was noted that disease recurrence was more frequent in patients with T2-T4 tumour stages [13% (12 out of 92 patients) with T2, 41% (32 out of 78 patients) with T3, and 80% (12 out of 15 patients) with T4 tumours]; this was statistically significant (P=0.0001).

The last characteristic that showed a significant risk for recurrence was lymphatic invasion, which was noted in 51% (46 out of 90 patients with disease recurrence) (P=0.008).

Conclusion: Our cohort study results show that patients <40 years old, with large tumour size (T), and lymphatic invasion have a significantly higher recurrence rate.

Gender, presence of vascular invasion, positive tumour margins, and radio-iodine ablation may have an impact on the chance of recurrence but were not statistically significant