Papillary thyroid cancer is characterized by slow growth, long disease history, and lymph node metastasis easily at early local stage. It often invades surrounding tissues and organs, such as trachea, esophagus, recurrent laryngeal nerve, and belt muscle, etc. The incidence of lymph node metastasis in the neck is higher, and sometimes bilateral tracheoesophageal groove or double neck lymph node metastasis occurs. Because of the high morbidity of patients with thyroid nodules, many hospitals cannot do rapid frozen pathological examination for clear diagnosis during surgery, and because some doctors have inadequate resection and clearance of papillary thyroid cancer and poor anatomy of the laryngeal recurrent nerve, resulting in irregular treatment of patients. Therefore, in order to better improve the survival rate and survival quality of patients, it is necessary to make the treatment of patients with papillary thyroid cancer more standardized in order to achieve the purpose of eradicating the tumor. Unlike lung cancer, esophageal cancer, gastric cancer, liver cancer, etc., where productivity is counted with 3 or 5 years, papillary thyroid cancer has higher productivity and is generally analyzed by 10-year survival rate. 45 years is the age cut-off in TNM staging, and distant metastasis below 45 years is the stage II, while the 10-year survival rates of stage I and II are 100.0% and 95.7%, respectively. Multifactorial regression analysis showed that age grouping, pathological differentiation and whether the trachea was invaded were independent prognostic influences, because age plays an important role in TNM staging,TNM for rating independent prognostic factors may be related to age conflict. Older age, heavier tumor involvement of surrounding tissues, and worse pathological grading were associated with lower survival rates. It is consistent with a large number of literature reports. If thyroid cancer invades the trachea, tracheal sleeve resection, sternocleidomastoid clavicle flap repair, partial tracheal resection tracheostomy and tracheal wall debridement to preserve the trachea can be done, all of which can achieve effective treatment. In general, the laryngeal nerve is dissected and protected during thyroid surgery, and paralysis of the laryngeal nerve is rare, except in cases of invasion of the laryngeal nerve. Most external thyroid surgery does not dissect the recurrent laryngeal nerve, which can easily lead to vocal cord paralysis, especially since there is a branch of the inferior thyroid artery crossing the recurrent laryngeal nerve into the larynx, and most external laryngeal nerve paralysis is caused by too many sutures here. Short-term nerve compression can be recovered after one month after relaxation, which can be clearly shown by indirect laryngoscopy. Chen Shicai et al. have also achieved good results in the treatment of recurrent laryngeal nerve palsy. Upper mediastinal lymph node metastases are often metastases from tracheoesophageal sulcus lymph nodes along the lymphatic return pathway to the upper mediastinum, and sometimes the upper mediastinal lymph node metastases and tracheoesophageal sulcus lymph node metastases fuse with each other. When the metastatic lymph nodes in the upper mediastinum have tissue traction in the neck and do not exceed the ability of the operator (2-4 cm), most of them can be resected or dissected via the neck, but when the metastatic lymph nodes in the upper mediastinum are more numerous, lower in position and exceed 2-4 cm, it is necessary to perform upper mediastinal lymph node dissection in cooperation with thoracic surgery. The surgical scope of thyroid cancer insists that only one lobe plus isthmus should be performed when the tumor is limited to one side, instead of total thyroidectomy. 16 cases of recurrence were found on the opposite side after this operation, and the recurrence rate is very low, which shows that this operation is scientifically based. It is necessary to perform postoperative radiotherapy for those who are not surgically resected or are suspected of not being resected with a low degree of pathological differentiation, and 131 iodine therapy is necessary for cases with distant metastases or those with a tendency to metastasize distantly. Papillary thyroid carcinoma grows slowly, and even recurrence has a large time span, and some of them even have recurrence in the neck or primary focus after 10 years. Even surgical areas that were once very cleanly excised have a certain recurrence rate, with recurrence in the tracheoesophageal groove at 4% and in the cervical lymph nodes at 6.1%. In addition to these predictable areas of recurrence, contralateral thyroid cancer and metastases in the non-affected cervical lymph nodes should also be noted at the time of patient review. Follow-up of patients with unclear tumor resection revealed that not all of them recurred, only 24.2% recurred, indicating that the tumor with little residual whether by isotope treatment, postoperative radiotherapy or observation, not all of them recurred. We analyzed the causes of death by following up the patients who died: for those aged below 45 years, all survived except one case due to hypofractionated cancer. In contrast, for those above 45 years of age, distant metastasis and multisite recurrence were the main causes of death, accounting for about 40.8%, while a single local recurrence or neck recurrence accounted for only 33.3%. This shows that controlling tumor recurrence and metastasis is the main means to reduce mortality. pelizzo MR reported that the prognostic factors of papillary thyroid cancer are related to age, extent of tumor involvement, extent of surgery and 131 iodine treatment after metastasis, which is consistent with our conclusion. In conclusion, the treatment of papillary thyroid carcinoma is mainly based on surgery with postoperative adjuvant isotope therapy and radiation therapy if necessary. TNM stage, tracheal invasion, clean resection or not, and degree of pathological differentiation are the main prognostic influencing factors. With the improvement of color ultrasound and cytological aspiration technology, the probability of preoperative confirmation of papillary thyroid cancer is increasing, especially the detection rate of bilateral thyroid cancer, bilateral tracheoesophageal sulcus and metastasis in both necks, which reduces the risk of surgery and improves the success rate of surgery. It also plays a role in the early detection of tumor recurrence and metastasis, which can further improve the survival rate.