Age and Post-Lobectomy Recurrence after Endoscopic or Robotic Thyroid Surgery: A Retrospective Cohort Study of 2348 Papillary Thyroid Carcinoma Patients

Simple Summary The biology of papillary thyroid carcinoma (PTC) in young patients is poorly understood, and there are conflicting data regarding recurrence for younger patients compared to older patients. We retrospectively analyzed 2348 clinically node-negative (cN0) PTC patients who underwent a thyroid lobectomy between 2008 and 2017. The clinicopathological characteristics and oncologic outcomes of young patients were compared to older patients. In the young age group, there was a significantly larger proportion of females, endoscopic/robotic thyroid lobectomy, large tumor sizes, and stage N1a. Post-lobectomy recurrences were higher in the young age group. In the Cox analysis, young age, large tumors, and stage N1a were significant risk factors. The multivariate analyses reveals that young age and stage N1a are significant risk factors. Conversely, minimally invasive and endoscopic/robotic thyroidectomies were not risk factors for post-lobectomy recurrence. Further studies are needed to elucidate the relationship between young age and the risk of post-lobectomy recurrence.Abstract The biology of papillary thyroid carcinoma (PTC) in young patients is poorly understood, and there are conflicting data regarding the recurrence for younger patients compared to older patients. We retrospectively analyzed 2348 clinically node-negative (cN0) PTC patients who underwent a thyroid lobectomy between 2008 and 2017. Young age was defined as less than 35 years old. The clinicopathological characteristics and oncologic outcomes of the young age group were compared to those of the older age group. The number of young age cN0 PTC patients accounted for 20.7% of the enrolled patients, and 24.2% were upstaged into pathologic N1a. The young age group had a significantly larger proportion of females, endoscopic/robotic thyroid lobectomies, stage N1a, and larger tumor sizes. Post-lobectomy recurrences were significantly higher in the young age group. In the Cox analysis, young age, large tumor size, and stage N1a were significant risk factors. The multivariate analysis reveals that young age and stage N1a are significant risk factors. Conversely, minimally invasive or robot-endoscopic thyroidectomies were not risk factors for post-lobectomy recurrence compared to conventional thyroidectomies. While young patients with a stage N1a had a significant risk factor for post-lobectomy recurrence, endoscopic/robotic thyroidectomy was as feasible and safe as conventional thyroidectomies in the median seven-year oncologic follow-up. Further high-quality studies are needed to elucidate the relationship between age and the risk of post-lobectomy recurrence.