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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2014

01-06-2014 | Endocrine Tumors

Risk Factors for Recurrence After Therapeutic Lateral Neck Dissection for Primary Papillary Thyroid Cancer

Authors: Su-jin Kim, MD, Seog Yun Park, MD, PhD, You Jin Lee, MD, PhD, Eun Kyung Lee, MD, PhD, Seok-ki Kim, MD, PhD, Tae Hyun Kim, MD, PhD, Yu-Seog Jung, MD, PhD, Junsun Ryu, MD, PhD, Jun Pyo Myong, MD, Ki-Wook Chung, MD, PhD

Published in: Annals of Surgical Oncology | Issue 6/2014

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Abstract

Background

Lateral lymph node metastasis is an important prognostic factor and is predictive of tumor recurrence and cause-specific survival in patients with papillary thyroid cancer (PTC). However, the factors predicting recurrence and clinical outcomes after therapeutic lateral neck dissection are not well established. The aims of this study were to evaluate the incidence, pattern, and factors predictive of PTC recurrence after therapeutic lateral neck dissection.

Materials and Methods

The records of 126 consecutive patients who underwent total thyroidectomy with therapeutic lateral neck dissection for primary PTC at the National Cancer Center were retrospectively reviewed. The factors predictive of recurrence were determined using both univariate and multivariate analyses considering several clinicopathologic variables.

Results

The median follow-up period was 61.2 months, during which 22 patients (17.5 %) experienced recurrence with 1 death (0.8 %) due to disease. Locoregional recurrence and distant metastasis were found in 20 cases (15.9 %) and 2 cases (1.6 %), respectively. Male gender, aggressive histology, number of lymph node metastases, initial level of T4-off Tg per ng/mL, and ATA risk categories (high risk) were independent risk factors for recurrence. Of note, initial T4-off Tg levels greater than 4.2 ng/mL showed highest sensitivity and specificity in predicting recurrence.

Conclusions

These results provide useful information regarding the clinical outcomes after therapeutic lateral neck dissection for primary PTC and can be used to identify at-risk patients who need aggressive treatment and intensive surveillance for postoperative recurrence.
Appendix
Available only for authorised users
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Metadata
Title
Risk Factors for Recurrence After Therapeutic Lateral Neck Dissection for Primary Papillary Thyroid Cancer
Authors
Su-jin Kim, MD
Seog Yun Park, MD, PhD
You Jin Lee, MD, PhD
Eun Kyung Lee, MD, PhD
Seok-ki Kim, MD, PhD
Tae Hyun Kim, MD, PhD
Yu-Seog Jung, MD, PhD
Junsun Ryu, MD, PhD
Jun Pyo Myong, MD
Ki-Wook Chung, MD, PhD
Publication date
01-06-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 6/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3507-y

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