{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T11:06:03Z","timestamp":1784545563231,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T00:00:00Z","timestamp":1724630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with intermediate\u2010risk papillary thyroid carcinoma (PTC) have a favorable prognosis with standard treatment of total thyroidectomy (TT) and adjuvant radioactive iodine therapy (RAIT). However, the benefits of TT or adjuvant RAIT remain undetermined, and they are often omitted in Japan. We investigated risk factors for life\u2010threatening distant recurrence in patients with intermediate\u2010risk PTC who are optimal candidates for adjuvant RAIT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>Outcomes without RAIT were retrospectively examined in 4030 intermediate\u2010risk conventional PTC cases underwent initial surgery from 2005 to 22 (IRB approval 20200709\u20101).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Lobectomy (LT) and TT was performed in 11.5% and 88.5%, respectively. Recurrent laryngeal nerve paralysis and hypoparathyroidism was less commonly observed in LT (1.3% and 0%) than TT (2.4% and 3.5 %). Fifty\u2010six cases (1.4%) had distant recurrence. Recurrence\u2010free survival rates at 10\u00a0years was 93.5%. There was no significant difference in recurrence rate between LT and TT. Age \u226555, cN1b, and tumor diameter &gt;30\u00a0mm significantly associated with distant recurrence. There was a strong relationship between the number of positive risk factors and recurrence; the distant recurrence rate in cases of 0, 1, 2, and 3 positive factors was 0.3% (4\/1203), 1.3% (25\/1889), 2.7% (23\/830) and 7.1% (4\/52) (HR 6.46 (2.34\u201317.86), Log\u2010rank &lt;0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For intermediate\u2010risk conventional PTC, there is no difference in prognosis even if LT was selectively conducted. However, in patients with risk factors for distant metastatic recurrence, such as age \u226555\u00a0years, cN1b, and tumor size &gt;30\u00a0mm, adjuvant RAIT was considered eligible.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12289","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T23:13:19Z","timestamp":1724713999000},"page":"117-123","source":"Crossref","is-referenced-by-count":3,"title":["Predictors of distant metastatic recurrence in intermediate\u2010risk papillary thyroid carcinoma"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4361-1827","authenticated-orcid":false,"given":"Naoyoshi","family":"Onoda","sequence":"first","affiliation":[{"name":"Department of Surgery Kuma Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2069-4658","authenticated-orcid":false,"given":"Yasuhiro","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Surgery Kuma Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Miya","sequence":"additional","affiliation":[{"name":"Department of Surgery Kuma Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minoru","family":"Kihara","sequence":"additional","affiliation":[{"name":"Department of Surgery Kuma Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Miyauchi","sequence":"additional","affiliation":[{"name":"Department of Surgery Kuma Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.ej20\u20100025"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.5781"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2019.01.010"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1530\/erc\u201015\u20100572"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.15001"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad171"},{"key":"e_1_2_10_9_1","volume-title":"TNM Classification of Malignant Tumours","author":"Brierley J. D.","year":"2017"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010023\u201007073\u20107"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010020\u201005429\u2010x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.ej19\u20100387"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0234843"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014\u20104332"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad045"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.760"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.12289","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T03:32:08Z","timestamp":1759894328000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.12289"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,26]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/wjs.12289"],"URL":"https:\/\/doi.org\/10.1002\/wjs.12289","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,26]]}}}