37
Figure 2. ATA 2025 Estimated Risk of Structural Recurrence
for PTC, FTC, and OTC
RISK OF
RECURRENCE
HIGH
>30%
INTERMEDIATE–
HIGH
≥16–30%
LOW–
INTERMEDIATE
10–15%
LOW
<10%
T3a + microscopic ETE, T3b, or T4;
or ANY T with any of the following:
Poorly differentiated or high grade
Gross incomplete resection (R2)
cN1 ≥3 cm
Extranodal extension (ENE)
Distant metastasis (M1)
T1, T2, or T3a with any of the following:
Bilateral multifocality >1 cm
Clinically evident lateral LN mets (cN1b) <3 cm
2+ Low-intermediate risk factors
Aggressive histology
Vascular invasion
T3a or; T1 or T2 with any of the following:
Unilateral multifocality
Microscopic ETE
cN1a or pN1a >2 mm
a
or >5LNs
Negative margins or
microscopic + posterior margin (R1)
T1 and T2 (≤4 cm):
Unifocal
pN0a, or cN0 and pN1a (≤5 LNs, all ≤2 mm)
Negative margins or
only microscopic + anterior margin (R1)
Estimated risk of recurrence up to 10 years
LEGEND:
a
No clear cutoffs for LNs between low-intermediate and high-intermediate risk groups. In general,
smaller size and fewer lymph node metastases are associated with lower risk of recurrence.
b
Lymph node metastases are uncommon in OTC and FTC/IEFVPTC.
c
WHO 2022 definition.
PTC and Subtypes
c
