• Γεώργιος Σακοράφας

Papillary / follicular (differentiated) thyroid cancer and recurrence (locoregional – distant

Differentiated (papillary / follicular) thyroid cancer (TC) in general has indolent characters and a relatively ‘benign’ biological behavior.

In some cases,  however, this common neoplasm has certain clinicopathological characters which may indicate a dire prognosis.

Factors associated with a high risk for disease recurrence (both locoregional [in the neck] as well as distant metastases) and unfavorable outcome include:

  1. Distant metastasis at the time of diagnosis

  2. Tumor size > 4 cm

  3. Gross extrathyroidal extension (macroscopic invasion of adjacent tissues / structures)

  4. Incomplete surgical excision

  5. Extensive vascular invasion

  6. Presence of positive node > 3 cm

  7. Extranodal tumor extension positive with > 3 lymph nodes involved

  8. Age > 55 years

  9. Follicular TC (as well as medullary TC)- metastasizes to distant sites more commonly than papillary thyroid cancer

  10. Aggressive histological variants of differentiated TC (such as tall/columnar variant of papillary thyroid cancer and insular/trabecular variant of follicular TC)

  11. Presence of BRAF-V600 mutation (should be evaluated in the context of other standard clinic-pathological risk factors)

The presence of these risk factors should be taken into consideration in the decision-making process regarding postoperative management and follow-up strategy.

J Clin Endocrinol Metab 2017; 102: 1254 Endocrine J 2019; 66: 127 Thyroid 2016; 26: 1

Papillary thyroid cancer - risk factors for recurrence

Papillary thyroid cancer - risk factors for recurrence

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