Recurrent Papillary Thyroid Carcinoma to the Cervical Lymph Nodes: Outcomes of Compartment-Oriented Lymph Node Resection
| Autor: | Bernardo Pérez-Enríquez, Raul Rivera-Moscoso, Miguel F. Herrera, Juan Pablo Pantoja, Mónica Chapa, David Velázquez-Fernández, Mauricio Sierra, Carlos Gustavo Rivera-Robledo |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty 030230 surgery Thyroid carcinoma Iodine Radioisotopes 03 medical and health sciences 0302 clinical medicine Postoperative Complications Medicine Humans Thyroid Neoplasms Lymph node Thyroid cancer Retrospective Studies business.industry Vascular surgery Middle Aged medicine.disease Surgery Dissection medicine.anatomical_structure Treatment Outcome Cervical lymph nodes Cardiothoracic surgery Thyroid Cancer Papillary 030220 oncology & carcinogenesis Lymphatic Metastasis Thyroidectomy Neck Dissection Female Lymph Nodes Neoplasm Recurrence Local business Abdominal surgery |
| Zdroj: | World journal of surgery. 43(11) |
| ISSN: | 1432-2323 |
| Popis: | Recurrence of papillary thyroid carcinoma after initial treatment is challenging. Surgical reintervention is recommended, but cure after surgery in uncertain and surgical morbidity may be high. This study evaluates the effect of compartment-oriented lymph node dissection (LND) on clinical and biochemical cure rate as well as the related complications. All patients who underwent LND for recurrent papillary thyroid carcinoma between 2000 and 2015 were included. Demography, the extent of the initial surgery, usage of 131I, the pattern of recurrence, diagnosis, details of the surgical reintervention, histological findings, surgical morbidity, and clinical and biochemical outcomes were analyzed. There were 11 (12.7%) males and 75 (87.2%) females with a mean age of 42.8 ± 14.6 years. Seventy-seven patients had undergone total thyroidectomy and in 67 (77.9%) some type of LN resection. In 76 (88.3%), 131I was administered after the initial surgery. We localized suspicious lymph nodes by US in all patients, and metastases were documented before surgery by FNA in 63. Seven (8.13%) patients underwent central LND, 63 (73.2%) lateral LND and 16 (18.6%) both, central and lateral LND. Major complications occurred in 6 patients (6.9%). Sixty-two (72.0%) patients received 131I after surgery. A second surgical re-exploration was performed in 30 (34.8%) patients, and 7 patients required 3 or more additional LND. In a mean follow-up of 59.4 ± 39 months, 51 (59.3%) patients are clinically, radiologically and biochemically free of disease. In this series, compartment-oriented lymph node resection of recurrent papillary thyroid carcinoma leads to a final clinical and biochemical disease-free status of 59.3% with 6.9% of major complications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink