Predictive Factors For The Recurrence Of Papillary Thyroid Cancer Following Resection At Dr. Soetomo General Hospital Indonesia

Abstract

BACKGROUND

Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, accounting for 80%–90% of cases, with generally favorable prognosis. However, recurrence occurs in a significant subset of patients and is associated with reduced long-term survival. Predictive factors such as tumor size, multifocality, lymph node metastasis, aggressive histology, and extrathyroidal extension have been identified, though their relevance may vary across populations. Given regional variations in clinical presentation and treatment outcomes, identifying locally relevant predictors is essential to optimize risk stratification and management. This study evaluates predictive factors for PTC recurrence following surgical resection at Dr. Soetomo General Hospital.

OBJECTIVES

This study aims to evaluate and analyze predictive factors associated with the recurrence of papillary thyroid carcinoma following surgical resection at Dr. Soetomo General Hospital.

METHODS

A retrospective cohort study was conducted using an analytical observational approach based on medical record data. The study analyzed potential predictors of recurrence in patients who underwent surgical resection for PTC between 2019 and 2024.

RESULTS

Multivariate logistic regression analysis identified several significant predictive factors for papillary thyroid carcinoma recurrence. Tumor size >5 cm was significantly associated with increased recurrence risk (p = 0.030; OR = 18.52). Extrathyroidal extension was also a strong predictor (p = 0.017; OR = 16.95), indicating that local invasion contributes to recurrence. Multifocal tumors significantly raised the likelihood of recurrence (p = 0.048; OR = 17.42), as did aggressive histological variants (p = 0.015; OR = 45.70). Lymph node metastasis showed a significant correlation with recurrence (p = 0.014; OR = 27.39), and the presence of lymphovascular invasion was also associated with higher risk (p = 0.026; OR = 13.56).

CONCLUSION

Tumor size >5 cm, extrathyroidal extension, multifocality, aggressive histological subtypes, lymph node metastasis, and lymphovascular invasion were found to be significant predictive factors for recurrence of papillary thyroid carcinoma. These findings highlight the importance of comprehensive risk stratification to guide surveillance and postoperative management strategies.