Minimal Extrathyroidal Extension in Bilateral Papillary Thyroid Carcinoma Is Associated With Postoperative Structural Recurrence

In patients with PTC, mETE is a significant prognostic factor of structural recurrence and is associated with decreased disease-free survival (DFS). Critically, we demonstrate for the first time that mETE elevates recurrence risk to near the ATA intermediate-high threshold (17.6%) in bilateral PTC, regardless of tumor size. This synergy of mETE and bilaterality supports upgrading risk stratification and intensifying surveillance for this subset.