The outcomes of first reoperation for locoregionally recurrent/persistent papillary thyroid carcinoma in patients who initially underwent total thyroidectomy and remnant ablation.

Abstract

CONTEXT:

The primary treatment of locoregionally recurrent/persistent papillary thyroid cancer (PTC) is surgical removal by reoperation. However, there had been only limited number of reports on the outcome of reoperation.

OBJECTIVE:

This study was to evaluate the efficacy of the first reoperation for locoregionally recurrent/persistent papillary thyroid carcinoma and the usefulness of stimulated thyroglobulin for evaluating efficacy of reoperation.

DESIGN AND SETTINGS:

This was a retrospective observational cohort study in a tertiary referral hospital.

PATIENTS:

A total of 83 patients, who underwent initial total thyroidectomy and nodal dissection with radioactive iodine remnant ablation, received reoperation for locoregionally recurrent/persistent PTC and were included in this study. Stimulated thyroglobulin levels were assessed before and after reoperation.

MAIN OUTCOME MEASURES:

We assessed biochemical remission (stimulated thyroglobulin <1 ng/ml) after reoperation and evaluated second clinical recurrence-free survival rate according to stimulated thyroglobulin value.

RESULTS:

There was a significant positive correlation between the numbers of resected malignant lymph nodes and the reduction in stimulated thyroglobulin level after reoperation. Biochemical remission was achieved in 51% of patients who underwent first reoperation. Patients with stimulated thyroglobulin level greater than 5 ng/ml after first reoperation had a greater chance of a second clinical recurrence (the estimated 5 yr clinical recurrence free survival rate, 94 ± 3 vs.74 ± 9%, log rank statistics 15.8, df = 1, P < 0.001).

CONCLUSION:

Surgery is an effective option for managing locally recurrent/persistent PTC. Stimulated thyroglobulin is a useful marker for evaluating efficacy of reoperation and predicting second recurrence in locoregionally recurrent/persistent PTC.

• Authors: Ji Hye Yim, Won Bae Kim, Eui Young Kim, Won Gu Kim, Tae Yong Kim, Jin-Sook Ryu, Gyungyub Gong, Suck Joon Hong, Young Kee Shong
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 96 Issue 7 Pg. 2049-56 (Jul 2011) ISSN: 1945-7197 [Electronic] United States
• PMID: 21508143 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aged
• Carcinoma, Papillary (pathology, surgery)
• Disease-Free Survival
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local (pathology, surgery)
• Remission Induction
• Reoperation
• Retrospective Studies
• Thyroid Neoplasms (pathology, surgery)
• Thyroidectomy
• Treatment Outcome