Risk factors in papillary thyroid cancer

: 270 patients with papillary thyroid carcinoma were retrospectively analyzed. The mean age at initial diagnosis was 43.5 years. 74% of the patients were females. 15 patients (6%) had residual tumor after initial surgery and 61 patients (24%) showed recurrent disease. The recurrence was discovered clinically, radiologically and by increasing thyroglobulin levels in 72%, 23% and 5% of the patients, respectively. Recurrent disease was located in the tumor bed, locally and metastatic and only metastatic in 61%, 23% and 16% of the patients, respectively. After a mean follow-up of 9.4 years (range 3-20 years) the overall mortality was 13%. 6% of the patients died from tumor, 3% with tumor and 4% without tumor. 46% of patients with residual tumor died from tumor progression, in contrast to 18% of patients with early recurrence ( 5 years). We conclude that papillary thyroid carcinoma has a low mortality (6%) even in an endemic area. Patients with residual tumor after initial surgery and patients with early recurrence have an increased cancer mortality.