{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T13:14:25Z","timestamp":1784294065156,"version":"3.55.0"},"reference-count":30,"publisher":"Korean Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:00:00Z","timestamp":1740441600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS-2022-NR069128"],"award-info":[{"award-number":["RS-2022-NR069128"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS-2018-NR032917"],"award-info":[{"award-number":["RS-2018-NR032917"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005006","name":"Asan Institute for Life Sciences, Asan Medical Center","doi-asserted-by":"publisher","award":["2024IL0008"],"award-info":[{"award-number":["2024IL0008"]}],"id":[{"id":"10.13039\/501100005006","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-enm.org"],"crossmark-restriction":true},"short-container-title":["Endocrinol Metab"],"published-print":{"date-parts":[[2025,6,30]]},"abstract":"<jats:p>Background: We aimed to investigate the prognostic significance of primary tumor size in patients with pT1\u2013T3a N0 M0 papillary thyroid carcinoma (PTC), minimizing the impact of confounding factors.Methods: A multicenter retrospective study included 5,759 patients with PTC. Those with lymph node metastasis, gross extrathyroidal extension (ETE), and aggressive variants were excluded. Patients were categorized by primary tumor size (\u22641, 1.1\u20132, 2.1\u20134, and &gt;4 cm) and subdivided based on the presence of microscopic ETE (mETE).Results: The median age was 48.0 years, and 87.5% were female. The median primary tumor size was 0.7 cm, with mETE identified in 43.7%. The median follow-up was 8.0 years, with an overall recurrent\/persistent disease rate of 2.8%. Multivariate analysis identified male sex, larger tumor size, and the presence of mETE as significant prognostic risk factors. The 10-year recurrent\/persistent disease rates for tumors \u22641, 1.1\u20132, 2.1\u20134, and &gt;4 cm were 2.5%, 4.7%, 11.1%, and 6.0%, respectively. The 2.1\u20134 cm group had a significantly higher hazard ratio (HR), with the &gt;4 cm group had the highest HR than the \u22641 cm group. Patients with mETE had a higher recurrent\/persistent disease rate (4.5%) than those without, with rates by tumor size being 2.6%, 5.6%, 16.7%, and 8.2%.Conclusion: Larger tumor size and the presence of mETE significantly increased the risk of recurrent\/persistent disease in PTC. Patients with pT2\u2013T3a N0 M0 PTC (&gt;2 cm) had a recurrent\/persistent disease risk exceeding 5%, warranting vigilant management.<\/jats:p>","DOI":"10.3803\/enm.2024.2199","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T23:49:56Z","timestamp":1740527396000},"page":"405-413","update-policy":"https:\/\/doi.org\/10.3803\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prognostic Impact of Primary Tumor Size in Papillary Thyroid Carcinoma without Lymph Node Metastasis"],"prefix":"10.3803","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3921-8635","authenticated-orcid":true,"given":"Chae A","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7865-0172","authenticated-orcid":true,"given":"Hye In","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3973-4669","authenticated-orcid":true,"given":"Na Hyun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4982-4441","authenticated-orcid":true,"given":"Tae Yong","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4544-1750","authenticated-orcid":true,"given":"Won Bae","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9563-5046","authenticated-orcid":true,"given":"Jae Hoon","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1297-107X","authenticated-orcid":true,"given":"Min Ji","family":"Jeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7975-2437","authenticated-orcid":true,"given":"Tae Hyuk","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6858-3439","authenticated-orcid":true,"given":"Sun Wook","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8404-7759","authenticated-orcid":true,"given":"Won Gu","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2119","reference":[{"key":"ref1","first-page":"1","volume-title":"2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer","author":"Haugen","year":"2016"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2019.0688"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-022-03059-y"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2011.09.007"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000005794"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2018-00081"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-022-02629-8"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.ej11-0288"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.ej12-0013"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2020.02.020"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0513"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1002\/jso.25182"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2009.0110"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21055"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2019.10088"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2008.0243"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0572"},{"key":"ref18","first-page":"93","volume-title":"The eighth edition AJCC cancer staging manual: continuing to build a bridge from a population-based to a more \u201cpersonalized\u201d approach to cancer staging","author":"Amin","year":"2017"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1996.00440180017002"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2006.16.109"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz400"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-1775"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.3803\/enm.2014.29.4.505"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1530\/eje-07-0896"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-17979-2"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1530\/erc-19-0085"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24051"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-005-0270-z"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0567"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-009-0375-x"}],"container-title":["Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-enm.org\/upload\/pdf\/enm-2024-2199.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-enm.org\/journal\/view.php?doi=10.3803\/EnM.2024.2199","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-enm.org\/upload\/pdf\/enm-2024-2199.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:10:44Z","timestamp":1751242244000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-enm.org\/journal\/view.php?doi=10.3803\/EnM.2024.2199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,30]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,6]]}},"URL":"https:\/\/doi.org\/10.3803\/enm.2024.2199","relation":{},"ISSN":["2093-596X","2093-5978"],"issn-type":[{"value":"2093-596X","type":"print"},{"value":"2093-5978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,30]]},"assertion":[{"value":"2024-10-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-25","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-30","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}