Background: As the incidence of papillary thyroid carcinoma (PTC) increases, optimal timing for surgical interventions remains undefined. While surgical delays are known to affect prognosis adversely in various cancers, their impact on PTC is controversial.

Methods: A retrospective study was conducted on 478 T1bN1-stage PTC patients treated at West China Hospital from January 2020 to May 2022. Patients underwent thyroidectomy with lymph node dissection and were categorized into three groups based on surgical delay: ≤90 days (group A, n = 264), > 90-180 days (group B, n = 92), and > 180 days (group C, n = 122). Additionally, patients were reclassified into two groups based on a one-year threshold: ≤365 days (group D, n = 420) and > 365 days (group E, n = 58). Tumor metastasis rates and postoperative complications were analyzed across these groups.

Results: The median surgical delay was 79 days, and the median follow-up was 1362 days. Tumor metastasis occurred in 1.67% (8 patients), while postoperative complications occurred in 5.65% (27 patients). Metastasis rates were 1.89%, 1.09%, and 1.64%, and complication rates were 5.68%, 4.35%, and 6.56% for groups A, B, and C, respectively. No statistically significant differences were observed in metastasis or complication rates among the three groups. Similarly, no significant differences were found between groups D and E in tumor metastasis (p = 1.000) or complication rates (p = 0.555).

Conclusion: Delayed surgery was not associated with significantly increased short-term tumor metastasis or postoperative complication rates in patients with T1bN1-stage PTC.

Keywords: Delayed surgery; Papillary thyroid carcinoma; Postoperative complications.; T1bN1-stage; Tumor metastasis.

© 2025. The Author(s).

背景： 随着乳头状甲状腺癌（PTC）发病率的增加，手术干预的最佳时机仍不确定。尽管已知手术延迟会负面影响各种癌症的预后，但其对PTC的影响仍有争议。

方法： 本研究回顾性分析了2020年1月至2022年5月在四川大学华西医院接受治疗的478例T1bN1期PTC患者。所有患者均接受了甲状腺切除术和淋巴结清扫，并根据手术延迟时间分为三组：≤90天（A组，n=264）、> 90-180天（B组，n=92）以及> 180天（C组，n=122）。此外，患者还被重新分类为两组，根据一年的阈值：≤365天（D组，n=420）和> 365天（E组，n=58）。分析了这些组之间的肿瘤转移率和术后并发症。

结果： 中位手术延迟时间为79天，中位随访时间1362天。肿瘤转移发生在1.67%（8名患者）的病例中，而术后并发症发生在5.65%（27名患者）的病例中。A、B和C组的转移率分别为1.89%，1.09% 和 1.64%，并发症发生率分别为5.68%，4.35% 和 6.56%。在三组之间未观察到转移或并发症发生率存在统计学显著差异。同样，D和E组之间的肿瘤转移（p = 1.000）或并发症发生率（p = 0.555）也没有发现显著差异。

结论： 对于T1bN1期PTC患者而言，手术延迟并未导致短期肿瘤转移率或术后并发症率的显著增加。

关键词： 延迟手术；乳头状甲状腺癌；术后并发症；T1bN1期；肿瘤转移。