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Published in: Endocrine 2/2019

01-02-2019 | Original Article

Risk factors for local recurrence following lateral neck dissection for papillary thyroid carcinoma

Authors: Marco Raffaelli, Carmela De Crea, Luca Sessa, Serena Elisa Tempera, Amanda Belluzzi, Celestino P. Lombardi, Rocco Bellantone

Published in: Endocrine | Issue 2/2019

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Abstract

Purpose

We aimed to evaluate risk factors for local recurrence following lateral neck dissection (LND) for papillary thyroid carcinoma (PTC).

Methods

Two hundred and nine patients who underwent therapeutic primary or reoperative LND for PTC were included.

Results

One hundred eighty-one patients underwent primary LND at our Institution, the remaining 28 were referred for recurrence following LND outside the Institution. Comparing patients who required reoperation for recurrent lateral neck disease with those who did not recur, no significant difference was found concerning sex, tumor size, multifocal disease, extracapsular invasion, histological variant, pT stage (P = NS). At univariate analysis, age, mean number of removed lateral neck nodes at first operation, the extent of initial LND and surgery performed outside the Institution were risk factors for recurrence (P < 0.001).

Conclusions

Limited LND and surgery performed at non referral Centers were non tumor-related risk factors for recurrence following therapeutic LND for PTC.
Literature
1.
go back to reference A.R. Shaha, J.P. Shah, T.R. Loree, Patterns of nodal and distant metastasis based on histologic varieties in differentiated carcinoma of the thyroid. Am. J. Surg. 172(6), 692–694 (1996)CrossRefPubMed A.R. Shaha, J.P. Shah, T.R. Loree, Patterns of nodal and distant metastasis based on histologic varieties in differentiated carcinoma of the thyroid. Am. J. Surg. 172(6), 692–694 (1996)CrossRefPubMed
2.
go back to reference J.L. Roh, J.Y. Park, C.I. Park, Total thyroidectomy plus neck dissection in differentiated papillary thyroid carcinoma patients: pattern of nodal metastasis, morbidity, recurrence, and postoperative levels of serum parathyroid hormone. Ann. Surg. 245(4), 604–610 (2007)CrossRefPubMedPubMedCentral J.L. Roh, J.Y. Park, C.I. Park, Total thyroidectomy plus neck dissection in differentiated papillary thyroid carcinoma patients: pattern of nodal metastasis, morbidity, recurrence, and postoperative levels of serum parathyroid hormone. Ann. Surg. 245(4), 604–610 (2007)CrossRefPubMedPubMedCentral
3.
go back to reference L.Y. Wang, F.L. Palmer, I.J. Nixon et al., Lateral neck lymph node characteristics prognostic of outcome in patients with clinically evident N1b papillary thyroid cancer. Ann. Surg. Oncol. 22(11), 3530–3536 (2015)CrossRefPubMedPubMedCentral L.Y. Wang, F.L. Palmer, I.J. Nixon et al., Lateral neck lymph node characteristics prognostic of outcome in patients with clinically evident N1b papillary thyroid cancer. Ann. Surg. Oncol. 22(11), 3530–3536 (2015)CrossRefPubMedPubMedCentral
4.
go back to reference C.W. Lee, J.L. Roh, G. Gong et al., Risk factors for recurrence of papillary thyroid carcinoma with clinically node-positive lateral neck. Ann. Surg. Oncol. 22, 117–124 (2015)CrossRefPubMed C.W. Lee, J.L. Roh, G. Gong et al., Risk factors for recurrence of papillary thyroid carcinoma with clinically node-positive lateral neck. Ann. Surg. Oncol. 22, 117–124 (2015)CrossRefPubMed
5.
go back to reference Y.M. Lee, T.Y. Sung, W.B. Kim, K.W. Chung, J.H. Yoon, S.J. Hong, Risk factors for recurrence in patients with papillary thyroid carcinoma undergoing modified radical neck dissection. Br. J. Surg. 103(8), 1020–1025 (2016)CrossRefPubMed Y.M. Lee, T.Y. Sung, W.B. Kim, K.W. Chung, J.H. Yoon, S.J. Hong, Risk factors for recurrence in patients with papillary thyroid carcinoma undergoing modified radical neck dissection. Br. J. Surg. 103(8), 1020–1025 (2016)CrossRefPubMed
6.
go back to reference V. Zaydfudim, I.D. Feurer, M.R. Griffin, J.E. Phay, The impact of lymph node involvement on survival in patients with papillary and follicular thyroid carcinoma. Surgery 144(6), 1070–1077 (2008). discussion 1077-1078CrossRefPubMed V. Zaydfudim, I.D. Feurer, M.R. Griffin, J.E. Phay, The impact of lymph node involvement on survival in patients with papillary and follicular thyroid carcinoma. Surgery 144(6), 1070–1077 (2008). discussion 1077-1078CrossRefPubMed
7.
go back to reference D.F. Schneider, H. Chen, R.S. Sippel, Impact of lymph node ratio on survival in papillary thyroid cancer. Ann. Surg. Oncol. 20(6), 1906–1911 (2013)CrossRefPubMed D.F. Schneider, H. Chen, R.S. Sippel, Impact of lymph node ratio on survival in papillary thyroid cancer. Ann. Surg. Oncol. 20(6), 1906–1911 (2013)CrossRefPubMed
8.
go back to reference K. Segal, R. Friedental, E. Lubin, J. Shvero, J. Sulkes, R. Feinmesser, Papillary carcinoma of the thyroid. Otolaryngol. Head. Neck. Surg. 113, 356–363 (1995)CrossRefPubMed K. Segal, R. Friedental, E. Lubin, J. Shvero, J. Sulkes, R. Feinmesser, Papillary carcinoma of the thyroid. Otolaryngol. Head. Neck. Surg. 113, 356–363 (1995)CrossRefPubMed
9.
go back to reference Y. Ito, T. Kudo, Y. Takamura, K. Kobayashi, A. Miya, A. Miyauchi, Lymph node recurrence in patients with N1b papillary thyroid carcinoma who underwent unilateral therapeutic modified radical neck dissection. World J. Surg. 36, 593–597 (2012)CrossRefPubMed Y. Ito, T. Kudo, Y. Takamura, K. Kobayashi, A. Miya, A. Miyauchi, Lymph node recurrence in patients with N1b papillary thyroid carcinoma who underwent unilateral therapeutic modified radical neck dissection. World J. Surg. 36, 593–597 (2012)CrossRefPubMed
10.
go back to reference C.P. Lombardi, M. Raffaelli, C. De Crea, L. Sessa, R. Bellantone, Morbidity of central neck dissection: primary surgery vs reoperation. Results a case-control study. Arch. Surg. 399, 747–753 (2014)CrossRef C.P. Lombardi, M. Raffaelli, C. De Crea, L. Sessa, R. Bellantone, Morbidity of central neck dissection: primary surgery vs reoperation. Results a case-control study. Arch. Surg. 399, 747–753 (2014)CrossRef
11.
go back to reference Y. Ito, T. Higashiyama, Y. Takamura et al., Risk factors for recurrence to the lymph node in papillary thyroid carcinoma patients without preoperatively detectable lateral neck node metastasis: validity of prophylactic modified radical neck dissection. World J. Surg. 31(11), 2085–2091 (2007)CrossRefPubMed Y. Ito, T. Higashiyama, Y. Takamura et al., Risk factors for recurrence to the lymph node in papillary thyroid carcinoma patients without preoperatively detectable lateral neck node metastasis: validity of prophylactic modified radical neck dissection. World J. Surg. 31(11), 2085–2091 (2007)CrossRefPubMed
12.
go back to reference M. Javid, E. Graham, J. Malinowski et al., Dissection of levels II through V is required for optimal outcomes in patients with lateral neck lymph node metastasis from papillary thyroid carcinoma. J. Am. Coll. Surg. 222(6), 1066–1073 (2016)CrossRefPubMed M. Javid, E. Graham, J. Malinowski et al., Dissection of levels II through V is required for optimal outcomes in patients with lateral neck lymph node metastasis from papillary thyroid carcinoma. J. Am. Coll. Surg. 222(6), 1066–1073 (2016)CrossRefPubMed
13.
go back to reference B.R. Haugen, E.K. Alexander, K.C. Bible et al., 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 26, 1–133 (2016)CrossRefPubMedPubMedCentral B.R. Haugen, E.K. Alexander, K.C. Bible et al., 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 26, 1–133 (2016)CrossRefPubMedPubMedCentral
14.
go back to reference F. Pacini, M. Schlumberger, H. Dralle et al., European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur. J. Endocrinol. 154, 787–803 (2016)CrossRef F. Pacini, M. Schlumberger, H. Dralle et al., European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur. J. Endocrinol. 154, 787–803 (2016)CrossRef
15.
go back to reference P. Perros, K. Boelaert, S. Colley et al., British Thyroid Association. Guidelines for the management of thyroid cancer. Clin. Endocrinol. 81(Suppl 1), 1–122 (2014)CrossRef P. Perros, K. Boelaert, S. Colley et al., British Thyroid Association. Guidelines for the management of thyroid cancer. Clin. Endocrinol. 81(Suppl 1), 1–122 (2014)CrossRef
16.
go back to reference B.C. Stack, R.L. Ferris, D. Goldenberg et al., American Thyroid Association consensus review and statement regarding the anatomy, terminology, and rationale for lateral neck dissection in differentiated thyroid cancer. Thyroid 22, 501–508 (2012)CrossRefPubMed B.C. Stack, R.L. Ferris, D. Goldenberg et al., American Thyroid Association consensus review and statement regarding the anatomy, terminology, and rationale for lateral neck dissection in differentiated thyroid cancer. Thyroid 22, 501–508 (2012)CrossRefPubMed
17.
go back to reference C.P. Hasney, R.G. Amedee, What is the appropriate extent of lateral neck dissection in the treatment of metastatic well-differentiated thyroid carcinoma? Laryngoscope 120(9), 1716–1717 (2010)CrossRefPubMed C.P. Hasney, R.G. Amedee, What is the appropriate extent of lateral neck dissection in the treatment of metastatic well-differentiated thyroid carcinoma? Laryngoscope 120(9), 1716–1717 (2010)CrossRefPubMed
18.
go back to reference N.R. Caron, Y.Y. Tan, J.B. Ogilvie et al., Selective Modified Radical Neck Dissection for Papillary Thyroid Cancer—Is Level I, II and V Dissection Always Necessary? World J. Surg. 30, 833–840 (2006)CrossRefPubMed N.R. Caron, Y.Y. Tan, J.B. Ogilvie et al., Selective Modified Radical Neck Dissection for Papillary Thyroid Cancer—Is Level I, II and V Dissection Always Necessary? World J. Surg. 30, 833–840 (2006)CrossRefPubMed
19.
go back to reference M.L. Urken, M. Milas, G.W. Randolph et al., Management of recurrent and persistent metastatic lymph nodes in well-differentiated thyroid cancer: a multifactorial decision-making guide for the Thyroid Cancer Care Collaborative. Head. Neck 37(4), 605–614 (2015)CrossRefPubMed M.L. Urken, M. Milas, G.W. Randolph et al., Management of recurrent and persistent metastatic lymph nodes in well-differentiated thyroid cancer: a multifactorial decision-making guide for the Thyroid Cancer Care Collaborative. Head. Neck 37(4), 605–614 (2015)CrossRefPubMed
20.
go back to reference A. Machens, R. Hinze, O. Thomusch, H. Dralle, Pattern of Nodal Metastasis for Primary and Reoperative Thyroid Cancer. World J. Surg. 26, 22–28 (2002)CrossRefPubMed A. Machens, R. Hinze, O. Thomusch, H. Dralle, Pattern of Nodal Metastasis for Primary and Reoperative Thyroid Cancer. World J. Surg. 26, 22–28 (2002)CrossRefPubMed
21.
go back to reference D.M. Hartl, S. Leboulleux, A.A. Ghuzlan et al., Optimization of staging of the neck with prophylactic central and lateral neck dissection for papillary thyroid carcinoma. Ann. Surg. 255, 777–783 (2012)CrossRefPubMed D.M. Hartl, S. Leboulleux, A.A. Ghuzlan et al., Optimization of staging of the neck with prophylactic central and lateral neck dissection for papillary thyroid carcinoma. Ann. Surg. 255, 777–783 (2012)CrossRefPubMed
22.
go back to reference A. Ohshima, H. Yamashita, S. Noguchi et al., Is a bilateral modified radical neck dissection beneficial for patients with papillary thyroid cancer? Surg. Today 32, 1027–1030 (2002)CrossRefPubMed A. Ohshima, H. Yamashita, S. Noguchi et al., Is a bilateral modified radical neck dissection beneficial for patients with papillary thyroid cancer? Surg. Today 32, 1027–1030 (2002)CrossRefPubMed
23.
go back to reference S. Uchino, S. Noguchi, H. Yamashita, S. Watanabe, Modified radical neck dissection for differentiated thyroid cancer: operative technique. World J. Surg. 28, 1199–1203 (2004)CrossRefPubMed S. Uchino, S. Noguchi, H. Yamashita, S. Watanabe, Modified radical neck dissection for differentiated thyroid cancer: operative technique. World J. Surg. 28, 1199–1203 (2004)CrossRefPubMed
24.
go back to reference J.R. Porterfield, D.A. Factor, C.S. Grant, Operative technique for modified radical neck dissection in papillary thyroid carcinoma. Arch. Surg. 144(6), 567–574 (2009)CrossRefPubMed J.R. Porterfield, D.A. Factor, C.S. Grant, Operative technique for modified radical neck dissection in papillary thyroid carcinoma. Arch. Surg. 144(6), 567–574 (2009)CrossRefPubMed
25.
go back to reference T. Farrag, F. Lin, N. Brownlee, Is routine dissection of level II-B and V-A necessary in patients with papillary thyroid cancer undergoing lateral neck dissection for FNA-confirmed metastases in other levels. World J. Surg. 33, 1680–1683 (2009)CrossRefPubMed T. Farrag, F. Lin, N. Brownlee, Is routine dissection of level II-B and V-A necessary in patients with papillary thyroid cancer undergoing lateral neck dissection for FNA-confirmed metastases in other levels. World J. Surg. 33, 1680–1683 (2009)CrossRefPubMed
26.
go back to reference M. Merdad, A. Eskander, T. Kroeker, J.L. Freeman, Predictors of level II and Vb neck disease in metastatic papillary thyroid cancer. Arch. Otolaryngol. Head. Neck Surg. 138(11), 1030–1033 (2012)CrossRefPubMed M. Merdad, A. Eskander, T. Kroeker, J.L. Freeman, Predictors of level II and Vb neck disease in metastatic papillary thyroid cancer. Arch. Otolaryngol. Head. Neck Surg. 138(11), 1030–1033 (2012)CrossRefPubMed
27.
go back to reference K. Welch, C.R. McHenry, Selective lateral compartment neck dissection for thyroid cancer. J. Surg. Res. 184(1), 193–199 (2013)CrossRefPubMed K. Welch, C.R. McHenry, Selective lateral compartment neck dissection for thyroid cancer. J. Surg. Res. 184(1), 193–199 (2013)CrossRefPubMed
28.
go back to reference D.T. Hughes, A.M. Laird, B.S. Miller, P.G. Gauger, G.M. Doherty, Reoperative lymph node dissection for recurrent papillary thyroid cancer and effect on serum thyroglobulin. Ann. Surg. Oncol. 19, 2951–2957 (2012)CrossRefPubMed D.T. Hughes, A.M. Laird, B.S. Miller, P.G. Gauger, G.M. Doherty, Reoperative lymph node dissection for recurrent papillary thyroid cancer and effect on serum thyroglobulin. Ann. Surg. Oncol. 19, 2951–2957 (2012)CrossRefPubMed
29.
go back to reference M. Salvatori, M. Raffaelli, P. Castaldi et al., Evaluation of the surgical completeness after total thyroidectomy for differentiated thyroid carcinoma. Eur. J. Surg. Oncol. 33, 648–654 (2007)CrossRefPubMed M. Salvatori, M. Raffaelli, P. Castaldi et al., Evaluation of the surgical completeness after total thyroidectomy for differentiated thyroid carcinoma. Eur. J. Surg. Oncol. 33, 648–654 (2007)CrossRefPubMed
30.
go back to reference American Joint Committee on Cancer. Thyroid. AJCC Cancer Staging Manual. 7th edn., Springer, New York. pp. 87−92 (2010) American Joint Committee on Cancer. Thyroid. AJCC Cancer Staging Manual. 7th edn., Springer, New York. pp. 87−92 (2010)
31.
go back to reference M. Raffaelli, C. De Crea, L. Sessa, G. Fadda, C. Bellantone, C.P. Lombardi, Ipsilateral central neck dissection plus frozen section examination versus prophylactic bilateral central neck dissection in cN0 papillary thyroid carcinoma. Ann. Surg. Oncol. 22, 2302–2308 (2015)CrossRefPubMed M. Raffaelli, C. De Crea, L. Sessa, G. Fadda, C. Bellantone, C.P. Lombardi, Ipsilateral central neck dissection plus frozen section examination versus prophylactic bilateral central neck dissection in cN0 papillary thyroid carcinoma. Ann. Surg. Oncol. 22, 2302–2308 (2015)CrossRefPubMed
32.
go back to reference C.P. Lombardi, M. Raffaelli, C. De Crea et al., Report on 8 years of experience with video assisted thyroidectomy for papillary thyroid carcinoma. Surgery 142, 944–951 (2007)CrossRefPubMed C.P. Lombardi, M. Raffaelli, C. De Crea et al., Report on 8 years of experience with video assisted thyroidectomy for papillary thyroid carcinoma. Surgery 142, 944–951 (2007)CrossRefPubMed
33.
go back to reference N. Chéreau, C. Buffet, C. Trésallet, F. Tissier, L. Leenhardt, F. Menegaux, Recurrence of papillary thyroid carcinoma with lateral cervical node metastases: Predictive factors and operative management. Surgery 159(3), 755–762 (2016)CrossRefPubMed N. Chéreau, C. Buffet, C. Trésallet, F. Tissier, L. Leenhardt, F. Menegaux, Recurrence of papillary thyroid carcinoma with lateral cervical node metastases: Predictive factors and operative management. Surgery 159(3), 755–762 (2016)CrossRefPubMed
34.
go back to reference J.Y. Park, B.S. Koo, Individualized optimal surgical extent of the lateral neck in papillary thyroid cancer with lateral cervical metastasis. Eur. Arch. Otorhinolaryngol. 271(6), 1355–1360 (2014)CrossRefPubMed J.Y. Park, B.S. Koo, Individualized optimal surgical extent of the lateral neck in papillary thyroid cancer with lateral cervical metastasis. Eur. Arch. Otorhinolaryngol. 271(6), 1355–1360 (2014)CrossRefPubMed
35.
go back to reference F.F. Palazzo, J. Gosnell, R. Savio et al., Lymphadenectomy for papillary thyroid cancer: changes in practice over four decades. Eur. J. Surg. Oncol. 32(3), 340–344 (2006)CrossRefPubMed F.F. Palazzo, J. Gosnell, R. Savio et al., Lymphadenectomy for papillary thyroid cancer: changes in practice over four decades. Eur. J. Surg. Oncol. 32(3), 340–344 (2006)CrossRefPubMed
Metadata
Title
Risk factors for local recurrence following lateral neck dissection for papillary thyroid carcinoma
Authors
Marco Raffaelli
Carmela De Crea
Luca Sessa
Serena Elisa Tempera
Amanda Belluzzi
Celestino P. Lombardi
Rocco Bellantone
Publication date
01-02-2019
Publisher
Springer US
Published in
Endocrine / Issue 2/2019
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-018-1788-9

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