CHANGING TRENDS IN PAPILLARY CARCINOMA THYROID –A STUDY OF LOCAL RECURRENCE AND INCIDENCE IN AGGRESSIVE VARIANTS OF PAPILLARY CARCINOMA, A SINGLE INSTITUTIONAL STUDY

Background: The incidence of papillary carcinoma thyroids have undoubtedlyincreased in India especially in the largely due to various high quality imaging studies obtained. Theclassical papillary carcinoma thyroid (PTC) is highly curable in 85% of the cases due to its slow biological behaviour but the aggressive variants of papillary carcinoma does not have the same biological behaviour.The clinical treatment of these aggressive PTC variants should be tailored to the disease stage, with an understanding that these variants are often associated with higher-risk features.

Methods: A prospective and retrospective observational study, where patients who underwent total thyroidectomy for papillary carcinoma thyroid from 2016 November to September 2022 are analysed. The incidence of aggressive variants, local recurrence rate and recurrence site and probable ethological and risk factors are collected.

Result: The overall trend among the aggressive variants of papillary carcinoma thyroid is on a steady raise in the past 5 years with female predominance n=105(60%). Out of 175 cases n= 54 (38.3%) showed local recurrence with highest recurrence for clear cell variant n= 4 ( 80%). The association of Long standing thyroiditis Out of 175 patients n=60 (34.3%) patients have thyroiditis at the time of diagnosis of papillary carcinoma and Warthins variant showed strongest association 85% and it was stasistically significant (p =0.005) while other habituations like alcohol, smoking and life style diseases like DM and HTN have no association with aggressive variants of PTC

Conclusion: It has been observed that there is consistent yearly increase in the incidence of aggressive variants of papillary carcinoma over the past 5 years with maximum number reported in the year 2021 -2022. The aggressive variants of PTC have been found to have more chance of Local recurrence and the most common site for local recurrence is Lymphnodes.Thyroiditis has been identified as an independent risk factor for developing aggressive variants of PTC, with statistical significance (p < 0.005).