• Jae Won Cho, Cheong-Sil Rah, Won Woong Kim, Yu-Mi Lee, Seong Chul Kim, Jung Hwan Baek, Dong Eun Song, Won Gu Kim, Ki-Wook Chung, Suck Joon Hong, and Tae-Yon Sung.
• Department of Surgery, Asan Medical Center, University of Ulsan Medical Center, Seoul, Korea.
• Yonsei Med. J. 2025 Jan 1; 66 (1): 435043-50.

PurposePediatric papillary thyroid cancer (PTC) is recommended to perform aggressive surgery to reduce the risk of recurrence. This study was designed to evaluate the concurrent association between multifocality, bilaterality, and the risk of recurrence in pediatric PTC.Materials And MethodsThis retrospective cohort study included pediatric patients (age <19 years) who underwent total thyroidectomy for PTC between 1996 and 2014 in a single tertiary center. Clinicopathological parameters were analyzed to evaluate the prevalence of multifocality, bilaterality, recurrence, and their association.ResultsWe analyzed 58 pediatric patients with PTC. There was no factor related to the presence of multifocality or bilaterality in multivariate analysis. Also, in univariate analysis, multifocality and bilaterality were not independent risk factors of each other's presentation (p=0.061 and p=0.061, respectively). Recurrence was observed in 19 (32.8%) patients. In multivariate analysis of recurrence, clear cell subtype, multifocality, and gross extrathyroidal extension (ETE) were independent risk factors (p=0.027, p=0.035, and p=0.038, respectively). Most recurrences (68.4%) happened during the first 4 years of follow-up after the initial thyroidectomy.ConclusionMultifocality and bilaterality were not independent risk factors of each other's presentation; however, multifocality was the risk factor for recurrence in pediatric PTC. For pediatric PTC, close monitoring for recurrence within the initial 4 years is recommended, particularly in patients with clear cell subtype, multifocality, and gross ETE.© Copyright: Yonsei University College of Medicine 2025.

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