Abstract Background Papillary thyroid carcinoma (PTC) is the most common malignant thyroid tumour, with a subset of patients presenting with advanced disease. The ESES recently refined the definition of advanced thyroid cancer. This study aimed to characterize clinical features, treatment patterns, and outcomes of patients with advanced PTC according to the updated ESES definition at a high-volume endocrine surgery center. Method In this monocentric, retrospective cohort study, all patients undergoing primary surgery for advanced PTC at the University Medical Center Mainz between 2015 and 2024 were included. Results Thirty-three patients were analysed (median age 54 years, 52% male, median Charlson Comorbidity Index CCI 2). Among 27 patients disease-free after surgery, 10 (37%) experienced recurrence, predominantly in lymph nodes and lung. Median recurrence-free survival was 11.4 months, and median progression-free survival in patients not disease-free after surgery (n = 6) was 6.0 months. Age 55 years was significantly associated with poorer survival (p = 0.005), while higher CCI showed a trend (p = 0.077). Logistic regression identified age (p = 0.037) and CCI (p = 0.024) as individual predictors of non-survival, but neither remained significant in the combined model, likely due to correlation (r = 0.402, p = 0.021). Male sex showed a non-significant trend toward higher recurrence risk (p = 0.058). Conclusion In this small exploratory cohort, older age and higher comorbidity were associated with reduced survival. Despite recurrences, long-term outcomes appeared relatively favourable for most patients. Larger studies are needed to confirm predictors of survival and recurrence.
Lederer et al. (Fri,) studied this question.