Long term outcomes after repeat lymph node dissections for persistent or recurrent differentiated thyroid cancer.

Autor: Barrio MJ; Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, University of Colorado School of Medicine, 12631 E 17th Ave., C-313 Mail Stop, Aurora, CO, 80045, United States., Pozdeyev N; Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, 12801 E. 17th Ave., 7103, Research 1 South, Aurora, CO, 80045, United States; Department of Biomedical Informatics, University of Colorado School of Medicine, 1890 N. Revere Court, Mailstop F600, Aurora, CO, 80045, United States., McIntyre RC Jr; Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, University of Colorado School of Medicine, 12631 E 17th Ave., C-313 Mail Stop, Aurora, CO, 80045, United States., Albuja-Cruz MB; Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, University of Colorado School of Medicine, 12631 E 17th Ave., C-313 Mail Stop, Aurora, CO, 80045, United States., Haugen BR; Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, 12801 E. 17th Ave., 7103, Research 1 South, Aurora, CO, 80045, United States., Raeburn CD; Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, University of Colorado School of Medicine, 12631 E 17th Ave., C-313 Mail Stop, Aurora, CO, 80045, United States. Electronic address: Christopher.raeburn@cuanschutz.edu.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2025 Jan; Vol. 239, pp. 116045. Date of Electronic Publication: 2024 Oct 24.
DOI: 10.1016/j.amjsurg.2024.116045
Abstrakt: Background: The primary treatment for locoregional recurrent/persistent differentiated thyroid cancer (DTC) is repeated lymph node dissection; however, there are limited reports on the safety and long-term efficacy of multiple operations.
Methods: Patients who underwent a cervical lymph node dissection between 1998 and 2022 were included in this study. Demographics, initial thyroid surgery, subsequent lymph node dissections, follow up information, and response to therapy were acquired.
Results: After one, two, three and four re-operations, 112/314 (35.7 ​%), 16/79 (20.3 ​%), 3/25 (12 ​%), and 0/3 (0 ​%) patients (p ​< ​0.001) had an excellent response, respectively, resulting in a cumulative rate of 41.7 ​% (131/314). The risk for permanent hypoparathyroidism (2.9 ​%) or recurrent laryngeal nerve injury (2.2 ​%) was 5.1 ​% (14/272). This was higher in patients undergoing re-operative central neck dissection (CNDx) (8.7 ​%, 10/114) versus those who did not undergo a previous CNDx (2.5 ​%, 4/158, p ​< ​0.02).
Conclusions: Surgery remains the primary treatment for recurrent/persistent DTC, however, the likelihood of an excellent response decreases with additional operations. The risk of permanent complications is low but is more likely to occur during redo CNDx.
Competing Interests: Declaration of competing interest Martin Jose Barrio: This author does not report any conflict of interest and no funding to disclose. Nikita Pozdeyev: This author does not report any conflict of interest and no funding to disclose. Robert C. McIntyre: This author does not report any conflict of interest and no funding to disclose. Maria B. Albuja Cruz: This author does not report any conflict of interest and no funding to disclose. Bryan Haugen: This author does not report any conflict of interest and no funding to disclose. Christopher D. Raeburn: This author does not report any conflict of interest and no funding to disclose.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: