UNASSIGNED: @entity3557 ( @entity3557 ) often presents as multifocal @entity5 ;, however, whether multifocality is associated with poor prognosis remains controversial. The aims of this retrospective study were to identify the characteristics of @entity3557 with @entity5 and evaluate the association between the location and prognosis. We reviewed the medical records of 496 @entity1 who underwent total thyroidectomy for @entity3557 . @entity1 were classified as three groups: N1 ( @entity5 ), N2 (2 or more foci within unilateral lobe of thyroid), and N3 ( @entity5 , at least one @entity5 focus for each lobe of thyroid). We analyzed the differences of clinicopathologic features and clinical outcomes among the three groups. Cox regression model was used to assess the relation between the different locations of @entity5 and prognosis. Although the differences of clinicopathologic features such as the size of @entity5 , extrathyroidal extension, and cervical @entity1600 were not significant among the three groups, the bilateral-multifocality was proved to be an independent risk factor for neck recurrence (hazard ratio (HR)   =   4.052, 95  % confidence interval (CI) 2.070-7.933), distant @entity3 (HR   =   3.860, 95  % CI 1.507-9.884), and @entity5 death (HR   =   7.252, 95  % 2.189-24.025). In addition, extrathyroidal extension (HR   =   2.291, 95  % CI 1.185-4.427) and older age >45  years (HR   =   6.721, 95  % CI 2.300-19.637) were also significant predictors for neck recurrence and @entity5 death, respectively. Therefore, bilateral-multifocality as an indicator for more extensive @entity5 location could be used to assess the risk of recurrence and mortality in @entity3557 . Given the poor prognosis associated with bilateral-multifocality and other risk factors, aggressive therapy and intensive follow-up were recommended for @entity3557 @entity1 with them.

Bilaterality weighs more than unilateral multifocality in predicting prognosis in XXXX .

@entity3557 :: ('MESH:C536915', 'Disease') :: ['Papillary thyroid cancer', 'PTC'] @entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'multifocal tumors', 'bilateral tumors', 'cancer', 'solitary tumor'] @entity1600 :: ('MESH:D014388', 'Disease') :: ['lymph node metastasis'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis']
@entity3557 :: (MESH:C536915,Disease) :: ['papillary thyroid cancer']
