Postoperative recurrence of papillary thyroid carcinoma with lymph node metastasis

<jats:sec><jats:title>Background and Objectives</jats:title><jats:p>: The purpose of this study was to retrospectively analyze the features of patients with papillary thyroid carcinoma (PTC) presenting with neck lymph node (LN) metastasis.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>: The study enrolled 909 patients with PTC who had undergone total thyroidectomy. After a median follow‐up of 14.6 years, 73 (8.0%) patients died of thyroid cancer. A total of 536 patients had the tumor confined to the thyroid (intra‐thyroid), 111 had lymph node (LN) metastasis, 225 showed soft tissue invasion, and 37 had distant metastasis.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>: Compared with the intra‐thyroid group, the group with LN metastases showed larger tumor size, higher postoperative thyroglobulin levels, advanced TNM stage, higher recurrence rates (5.2% vs. 31.5%), and higher disease‐specific mortality (1.3% vs. 12.6%). Of the 111 patients with PTC and LN metastases, 35 (31.5%) were diagnosed with recurrence during a mean follow‐up period of 16.9 ± 0.6 years. Among the 35 patients with recurrent PTC, 14 (40.0%) died of thyroid cancer. The mortality group was characterized by older, mostly male patients who presented with larger initial tumor size compared with survivors.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>: In patients with PTC, the rates of recurrence and cancer mortality were higher in the group with LN metastasis than that in the intra‐thyroid tumor group. <jats:italic>J. Surg. Oncol. 2015 111:149–154</jats:italic>. © 2015 The Authors. <jats:italic>Journal of Surgical Oncology</jats:italic> Published by Wiley Periodicals, Inc.</jats:p></jats:sec>