{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T23:49:13Z","timestamp":1789602553782,"version":"build-2803163510"},"reference-count":21,"publisher":"Korean Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-enm.org"],"crossmark-restriction":true},"short-container-title":["Endocrinol Metab"],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:p>Background: This study investigated the prognostic value of bilaterality and multifocality in papillary thyroid carcinoma (PTC) recurrence, aiming to inform optimal surgical strategies.Methods: In this retrospective cohort, 1,966 patients who underwent total thyroidectomy for PTC (2011\u20132014) were categorized into four groups according to tumor multifocality and bilaterality confirmed by postoperative histopathology: group 1, unilateral solitary; group 2, unilateral multifocal; group 3, bilateral solitary; group 4, bilateral multifocal. Clinicopathologic features and clinical outcomes were compared across these groups.Results: Group 4 exhibited the highest prevalence of BRAFV600E positivity, nodal metastases, and recurrence. Both bilaterality and multifocality were associated with more aggressive clinicopathologic characteristics. Recurrence risk increased with the number of tumor foci, with the odds ratio (OR) significantly elevated for more than five foci. Satellite pattern was strongly linked to recurrence (OR, 19.49; P&lt;0.001). While tumor multifocality (\u22655 foci) and bilaterality were associated with recurrence in univariate analyses, these associations were not independent after adjustment. Kaplan-Meier analysis demonstrated the lowest recurrence-free survival (RFS) in group 4. Patients with bilateral disease had significantly lower RFS than those with unilateral disease (P=0.003), whereas multifocality did not significantly affect RFS compared to solitary disease (P=0.095).Conclusion: Tumor bilaterality, multifocality (\u22655 foci), and satellite pattern were associated with aggressive features and higher recurrence risk. Although not independent predictors, these factors may serve as useful surrogate markers of aggressive disease biology and help guide personalized surgical strategies in patients with PTC.<\/jats:p>","DOI":"10.3803\/enm.2025.2607","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T04:43:01Z","timestamp":1772599381000},"page":"288-299","update-policy":"https:\/\/doi.org\/10.3803\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of Tumor Bilaterality and Multifocality in Predicting Recurrence of Papillary Thyroid Carcinoma: A Retrospective Cohort Study"],"prefix":"10.3803","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0484-0588","authenticated-orcid":true,"given":"Eunji","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Thyroid & Endocrine Surgery, Kyungpook National University Chilgok Hospital, Daegu, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7800-6555","authenticated-orcid":true,"given":"Jun Hyun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Thyroid & Endocrine Surgery, Kyungpook National University Chilgok Hospital, Daegu, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7571-1064","authenticated-orcid":true,"given":"Ji-Young","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Pathology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2607-1686","authenticated-orcid":true,"given":"Jin Hyang","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Thyroid & Endocrine Surgery, Kyungpook National University Chilgok Hospital, Daegu, Korea"},{"name":"Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7196-5366","authenticated-orcid":true,"given":"Sang-Woo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea"}],"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":"10.1177\/10507256251363120"},{"key":"ref3","first-page":"1","volume-title":"Korean Thyroid Association guidelines on the management of differentiated thyroid cancers; 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