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European Archives of Oto-Rhino-Laryngology
Published in: European Archives of Oto-Rhino-Laryngology 6/2019

01-06-2019 | Thyroid Cancer | Head & Neck

Radioguided occult lesion localization in patients with recurrent thyroid cancer

Authors: Murat Tuncel, Nilda Süslü

Published in: European Archives of Oto-Rhino-Laryngology | Issue 6/2019

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Abstract

Purpose

Well planned re-surgery is critical for recurrent/persistent thyroid cancer (TC). We aimed to investigate the clinical outcome of radioguided-occult lesion localization (ROLL) guided surgery in patients with recurrent/persistent TC.

Methods

This study includes 29 patients [F/M: 22/7, median age 43 ± 12 years (18–58)] with a diagnosis of TC (22 papillary, 2 follicular and 5 medullary). Before surgery, all patients underwent ultrasonography (USG) guided mapping and intra-lesional radioactivity injection. Surgery was performed based on the excision of radioactivity injected lesions by a gamma probe and non-injected tumor foci via USG-neck map. Researchers determined surgical success by post-operative tumor markers and neck-USG.

Results

Among 29 patients, 60 metastatic lesions were identified by USG [median size 10 ± 6.3 mm (range 5–30)]. Neck-USG performed after surgery provided no evidence of disease (NED) in %97 (28/29) of TC patients. In the follow-up, stimulated thyroglobulin (Tg) levels were less than 1 ng/ml in 79%(19/24) of DTC patients and suppressed Tg < 0.2 ng/ml was noted in 92% (22/24).In patients with DTC with an incomplete structural response, we dramatically changed the American Thyroid Association (ATA) response category and achieved an excellent response in 92% (22/24) of patients. Among patients with MTC, 5/5 patients had normal USG and calcitonin levels were reduced by 60–80% in 4/5 and > 80% in1/5 patients.

Conclusions

In this study we have shown that, ROLL-guided surgery yielded NED rate of %97 (28/29) and increased excellent response rates according to ATA guidelines. Further studies with larger patient groups and longer follow-up should be performed to confirm the efficacy of this surgery.
Literature
1.
American Thyroid Association Guidelines Taskforce on Thyroid N, Differentiated Thyroid C, Cooper DS, Doherty GM, Haugen BR, Kloos RT et al (2009) Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19(11):1167–1214CrossRef
2.
Mazzaferri EL, Kloos RT (2001) Clinical review 128: current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab 86(4):1447–1463CrossRefPubMed
3.
Landis SH, Murray T, Bolden S, Wingo PA (1998) Cancer statistics, 1998. CA Cancer J Clin 48(1):6–29CrossRefPubMed
4.
Mazzaferri EL, Jhiang SM (1994) Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med 97(5):418–428CrossRefPubMed
5.
Shen WT, Ogawa L, Ruan D, Suh I, Kebebew E, Duh QY et al (2010) Central neck lymph node dissection for papillary thyroid cancer: comparison of complication and recurrence rates in 295 initial dissections and reoperations. Arch Surg 145(3):272–275CrossRefPubMed
6.
Pai SI, Tufano RP (2010) Reoperation for recurrent/persistent well-differentiated thyroid cancer. Otolaryngol Clin North Am 43(2):353–363CrossRefPubMed
7.
Onkendi EO, McKenzie TJ, Richards ML, Farley DR, Thompson GB, Kasperbauer JL et al (2014) Reoperative experience with papillary thyroid cancer. World J Surg 38(3):645–652CrossRefPubMed
8.
Shaha AR, Jaffe BM (1998) Parathyroid preservation during thyroid surgery. Am J Otolaryngol 19(2):113–117CrossRefPubMed
9.
Levin KE, Clark AH, Duh QY, Demeure M, Siperstein AE, Clark OH (1992) Reoperative thyroid surgery. Surgery 111(6):604–609PubMed
10.
Goretzki PE, Simon D, Frilling A, Witte J, Reiners C, Grussendorf M et al (1993) Surgical reintervention for differentiated thyroid cancer. Br J Surg 80(8):1009–1012CrossRefPubMed
11.
Tisell LE, Hansson G, Jansson S, Salander H (1986) Reoperation in the treatment of asymptomatic metastasizing medullary thyroid carcinoma. Surgery 99(1):60–66PubMed
12.
Triponez F, Poder L, Zarnegar R, Goldstein R, Roayaie K, Feldstein V et al (2006) Hook needle-guided excision of recurrent differentiated thyroid cancer in previously operated neck compartments: a safe technique for small, nonpalpable recurrent disease. J Clin Endocrinol Metab 91(12):4943–4947CrossRefPubMed
13.
Rubello D, Salvatori M, Pelizzo MR, Rampin L, Fanti S, Gregianin M et al (2006) Radio-guided surgery of differentiated thyroid cancer using (131)I or 99mTc-Sestamibi. Nucl Med Commun 27(1):1–4CrossRefPubMed
14.
Ilgan S, Ozturk E, Yildiz R, Emer O, Ayan A, Gorgulu S et al (2010) Combination of preoperative ultrasonographic mapping and radioguided occult lesion localization in patients with locally recurrent/persistent papillary thyroid carcinoma: a practical method for central compartment reoperations. Clin Nucl Med 35(11):847–852CrossRefPubMed
15.
American Thyroid Association Surgery Working G, American Association of Endocrine S, American Academy of O-H, Neck S, American H, Neck S et al (2009) Consensus statement on the terminology and classification of central neck dissection for thyroid cancer. Thyroid 19(11):1153–1158CrossRef
16.
Stack BC Jr, Ferris RL, Goldenberg D, Haymart M, Shaha A, Sheth S et al (2012) American thyroid association consensus review and statement regarding the anatomy, terminology, and rationale for lateral neck dissection in differentiated thyroid cancer. Thyroid 22(5):501–508CrossRefPubMed
17.
Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE et al (2016) 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):1–133CrossRefPubMedPubMedCentral
18.
McCoy KL, Yim JH, Tublin ME, Burmeister LA, Ogilvie JB, Carty SE (2007) Same-day ultrasound guidance in reoperation for locally recurrent papillary thyroid cancer. Surgery 142(6):965–972CrossRefPubMed
19.
20.
Tufano RP, Clayman G, Heller KS, Inabnet WB, Kebebew E, Shaha A et al (2015) Management of recurrent/persistent nodal disease in patients with differentiated thyroid cancer: a critical review of the risks and benefits of surgical intervention versus active surveillance. Thyroid 25(1):15–27CrossRefPubMed
21.
Hughes DT, Laird AM, Miller BS, Gauger PG, Doherty GM (2012) Reoperative lymph node dissection for recurrent papillary thyroid cancer and effect on serum thyroglobulin. Ann Surg Oncol 19(9):2951–2957CrossRefPubMed
22.
Harari A, Sippel RS, Goldstein R, Aziz S, Shen W, Gosnell J et al (2012) Successful localization of recurrent thyroid cancer in reoperative neck surgery using ultrasound-guided methylene blue dye injection. J Am Coll Surg 215(4):555–561CrossRefPubMed
23.
Rubello D, Salvatori M, Ardito G, Mariani G, Al-Nahhas A, Gross MD et al (2007) Iodine-131 radio-guided surgery in differentiated thyroid cancer: outcome on 31 patients and review of the literature. Biomed Pharmacother 61(8):477–481CrossRefPubMed
24.
Giles YS, Sarici IS, Tunca F, Sormaz IC, Salmaslioglu A, Adalet I et al (2014) The rate of operative success achieved with radioguided occult lesion localization and intraoperative ultrasonography in patients with recurrent papillary thyroid cancer. Surgery 156(5):1116–1126CrossRefPubMed
25.
Bellotti C, Castagnola G, Tierno SM, Centanini F, Sparagna A, Vetrone I et al (2013) Radioguided surgery with combined use of gamma probe and hand-held gamma camera for treatment of papillary thyroid cancer locoregional recurrences: a preliminary study. Eur Rev Med Pharmacol Sci 17(24):3362–3366PubMed
26.
Lee L, Steward DL (2008) Sonographically-directed neck dissection for recurrent thyroid carcinoma. Laryngoscope 118(6):991–994CrossRefPubMed
27.
Gulcelik MA, Karaman N, Dogan L, Sahiner I, Akgul GG, Kahraman YS et al (2017) Radioguided occult lesion localization for locally recurrent thyroid carcinoma. Eur Arch Otorhinolaryngol 274(7):2915–2919CrossRefPubMed
28.
Rondeau G, Fish S, Hann LE, Fagin JA, Tuttle RM (2011) Ultrasonographically detected small thyroid bed nodules identified after total thyroidectomy for differentiated thyroid cancer seldom show clinically significant structural progression. Thyroid 21(8):845–853CrossRefPubMedPubMedCentral
29.
30.
Rowland KJ, Jin LX, Moley JF (2015) Biochemical cure after reoperations for medullary thyroid carcinoma: a meta-analysis. Ann Surg Oncol 22(1):96–102CrossRefPubMed
31.
Lee HS, Roh JL, Gong G, Cho KJ, Choi SH, Nam SY et al (2015) Risk factors for re-recurrence after first reoperative surgery for locoregional recurrent/persistent papillary thyroid carcinoma. World J Surg 39(8):1943–1950CrossRefPubMed
32.
Cayonu M, Acar A, Eryilmaz A, Oguz O (2014) Surgical approach and outcomes for revision surgery of the central neck compartment. J Craniofac Surg 25(5):1797–1800CrossRefPubMed
Metadata
Title
Radioguided occult lesion localization in patients with recurrent thyroid cancer
Authors
Murat Tuncel
Nilda Süslü
Publication date
01-06-2019
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 6/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-019-05377-w

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