With the recent expansion in the number and size of unit checkups, more and more thyroid nodules are being detected. In addition to further visits to our thyroid center for specialty review and risk stratification, more of our outpatients are in our center for lifelong review and thyroid function maintenance. One of the most worried and disturbed patients is the post-operative thyroid cancer group, which is the largest group of patients we see daily. The majority of these patients are papillary thyroid cancer and a small number of follicular thyroid cancer patients. These patients are very nervous and helpless because of the results of the sudden physical examination and surgery; they are in a constant state of panic about “cancer” and are torn between postoperative recurrence and treatment options. Although surgeons have told us that this type of malignant tumor has a very special biological behavior and its natural process is very slow compared to other malignant tumors, especially for differentiated thyroid cancer (papillary carcinoma accounts for more than 95%) with a diameter of about 1 cm found by physical examination, the effect after surgery is very certain! There are big data studies showing that its mortality rate 30 years after surgery is less than 1%, i.e. it is comparable to the natural accidental mortality rate of human beings. Therefore, to worry about the fear of dying from the disease after surgery is pure “excessive anxiety”! Because of the inappropriate propaganda by various “media” and networks in the society, the role of “cancer fear” has been amplified, which may lead individual patients who are psychologically “fragile” to the possibility of collapse and despair. Therefore, we hope that patients must seriously and quietly understand that the curability of such tumors is very certain; when doctors rely on telling you that this good prognosis is true, and not so-called “friendly” with your family to lie to you or comfort you. Understanding this is important for your post-operative psychological and physical recovery. Postoperative Recurrence Rates of Papillary Thyroid Although we say that this type of tumor does not lead to increased mortality after surgery, it is a common feature of malignant tumors that can recur or even metastasize to regional lymph nodes or distant organs; long-term observational studies with large data show that the recurrence rate after “radical” surgery increases slowly over time. In general, the overall recurrence rate is about 30% in the ten years after surgery. Therefore, the fear of “postoperative recurrence” is a huge “psychological problem” that makes patients panic and struggle! The good thing is that, as we said above, even if you have a “recurrence”, it will not affect your natural life expectancy, because the time from its “recurrence” to your death is longer than your natural life expectancy! Moreover, the probability of this happening is less than 1%. Therefore, it is not necessary to worry and worry about the recurrence and death! However, we are very concerned about your recurrence, and this is the main reason why we have to review you regularly throughout your life. Although the mortality rate of recurrence is very small, the assessment of the impact of recurrence and metastasis on survival and quality of life in some of these areas is a very important and specialized issue. This is where specialists learn how to reduce postoperative recurrence or identify patients who are at higher risk of recurrence and need further treatment during the review. How to prevent recurrence of papillary thyroid cancer after surgery? First of all, it is naive to say that the idea of preventing recurrence after surgery is zero! If any “expert” tells you that there is no recurrence after surgery, then he must be a “bricklayer”! Secondly, the rate of recurrence after surgery is really related to the biological personality of the tumor itself, the level and standardization of the radical surgery technique, the scientific and reasonable formulation of the postoperative comprehensive treatment, and the timely and effective postoperative follow-up. I would like to focus here on the surgical factors that affect postoperative recurrence, which is the most important factor affecting postoperative recurrence of small papillary thyroid cancer, namely the level of operator’s technique and surgical standardization. In the last decade, theoretical research and technical progress of thyroid surgery are rapidly maturing and developing with the rapid growth of patients. However, there are only a limited number of specialized physicians and scholars who were able to keep abreast of the developments and clinical research advances in the discipline in earlier years and were able to originate or develop them in the Chinese environment! Therefore, most of the patients would be treated in general surgery (or even non-general surgery) or head and neck surgery in different hospitals at all levels; the difference in their surgical concepts and levels was great, and the lack of grasp of surgical techniques, the inability to keep up with the concept of application of new techniques and equipment devices, and the lack of awareness and techniques to prevent surgical complications all seriously affected the thoroughness of radical tumor treatment. Therefore, the recurrence rate at that time was high. For this reason, the first general surgery department of the First Affiliated Hospital of Kunming Medical University opened the first outpatient thyroid surgery clinic in our province in 1997, and then established the thyroid surgery department together with the gastrointestinal surgery department in 2005 to gradually bring the technical concept and level of thyroid surgery in our province in line with the advanced units in China and pay attention to the international dynamic development. In 2009, we became a provincial thyroid clinical research center awarded by the provincial health department; at that time, this was one of the representatives of our province in the forefront of the construction of professional institutions in China. In 2012, our department was established as a center for the diagnosis and treatment of thyroid diseases, which is a branch of the Department of General Surgery, and has joined with the Department of Ultrasound Imaging, Nuclear Medicine, Pathology and Endocrinology to form a truly advanced platform for the diagnosis and treatment of thyroid tumors in line with international standards. The data shows that our center has the largest cumulative number of thyroid cancer cases in the province, and the recurrence rate is decreasing year by year. This is the great social benefit of specialized treatment! Nevertheless, there are still more patients who are treated in traditional surgery in the majority of primary care hospitals in our province, which is the reason why our center has to keep trying to promote advanced technology and theoretical advances. At the same time, we also see that the primary care doctors are constantly learning, exchanging and improving, and working hard to lower the recurrence of thyroid tumors after surgery. This is the common desire and purpose of all of us. Therefore, although the postoperative recurrence problem that patients are concerned about today is “strategically” despised by professional doctors, it has always been a research and development direction of great concern and importance for global colleagues to completely eradicate it from the “technical” point of view. In the next lecture, I will continue to discuss how to look at “relapse” and how to treat it properly.