A high Ki-67 labeling index and high thyroglobulin doubling rate are significant predictors of excision-site recurrence of papillary thyroid carcinoma following airway resection for locally curative surgery.

Autor: Ito Y; Department of Surgery, Kuma Hospital, Kobe, Japan., Miyauchi A; Department of Surgery, Kuma Hospital, Kobe, Japan., Hirokawa M; Diagnostic Pathology and Cytology, Kuma Hospital, Kobe, Japan., Kawakami M; Medical Information Management Section, Kuma Hospital, Kobe, Japan., Kihara M; Department of Surgery, Kuma Hospital, Kobe, Japan., Onoda N; Department of Surgery, Kuma Hospital, Kobe, Japan., Miya A; Department of Surgery, Kuma Hospital, Kobe, Japan.
Jazyk: angličtina
Zdroj: World journal of surgery [World J Surg] 2024 Oct; Vol. 48 (10), pp. 2452-2462. Date of Electronic Publication: 2024 Sep 09.
DOI: 10.1002/wjs.12325
Abstrakt: Background: Papillary thyroid carcinoma (PTC) occasionally invades the trachea and requires airway resection. Tracheal excision site recurrence (ESR) is a serious problem. We investigated predictors of ESR in patients with PTC who underwent airway resection for locally curative surgery.
Methods: We enrolled 149 patients with PTC who underwent airway resection (median age at the initial surgery: 67 years), including partial-thickness resection (n = 73) or full-thickness resection (n = 76), for grossly curative surgery. The median postoperative follow-up period was 93 months.
Results: To date, 11 patients (6.7%) underwent ESR: 6 underwent full-thickness resection and 5 underwent partial-thickness resection. The time to ESR ranged from 14 to 113 months (median: 57 months) after the initial surgery. None of the 11 ESR patients underwent adjuvant external beam radiotherapy (EBRT) and none of the 4 airway resection patients who underwent EBRT developed ESR. The 5- and 10-year ESR rates were 4.3% and 11.3%, respectively. In the multivariate analysis (forward-backward stepwise selection method), a Ki-67 labeling index (LI) ≥5% (p = 0.048) and the thyroglobulin doubling rate (Tg-DR) >0.33/year (p = 0.009) (for Tg-antibody negative cases) were independent predictors of ESR. Nine of the 11 patients underwent ESR resection and only one developed a second recurrence.
Conclusions: A high Ki-67 LI was a static predictor, and high Tg-DR was a dynamic predictor, of ESR in patients with PTC following airway resection. In such patients, careful postoperative monitoring for ESR is necessary and adjuvant therapies, such as EBRT, may be considered.
(© 2024 The Author(s). World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).)
Databáze: MEDLINE
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