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01-11-2019 | Metastasis | Original Scientific Report

Recurrent Papillary Thyroid Carcinoma to the Cervical Lymph Nodes: Outcomes of Compartment-Oriented Lymph Node Resection

Authors: Carlos Gustavo Rivera-Robledo, David Velázquez-Fernández, Juan Pablo Pantoja, Mauricio Sierra, Bernardo Pérez-Enriquez, Raul Rivera-Moscoso, Mónica Chapa, Miguel F. Herrera

Published in: World Journal of Surgery | Issue 11/2019

Abstract

Introduction

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.

Patients and methods

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.

Results

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.

Conclusions

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.

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Title: Recurrent Papillary Thyroid Carcinoma to the Cervical Lymph Nodes: Outcomes of Compartment-Oriented Lymph Node Resection
Authors: Carlos Gustavo Rivera-Robledo
David Velázquez-Fernández
Juan Pablo Pantoja
Mauricio Sierra
Bernardo Pérez-Enriquez
Raul Rivera-Moscoso
Mónica Chapa
Miguel F. Herrera
Publication date: 01-11-2019
Publisher: Springer International Publishing
Keyword: Metastasis
Published in: World Journal of Surgery / Issue 11/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05094-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Recurrent Papillary Thyroid Carcinoma to the Cervical Lymph Nodes: Outcomes of Compartment-Oriented Lymph Node Resection

Abstract

Introduction

Patients and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Patients and methods

Results

Conclusions

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