Sevim Turanli1, Sabahattin Aslan, Abdullah Cetin. 1. Department of General Surgery, Ankara Oncology Education and Research Hospital, Ankara Turkey. turanlisevim@hotmail.com
Abstract
PURPOSE: Total or near-total thyroidectomy is advocated in reducing the recurrence rate and improving survival in differentiated thyroid carcinoma. However, this potential benefit could be seen in all patient groups or only in the patients who have multifocal disease. We analyzed the clinical significance of occult multifocal disease in patients with completion thyroidectomy. PATIENTS AND METHODS: Ninety-seven patients in whom the completion thyroidectomy was performed within 6 months were included. The patients were grouped according to whether they have malignancy in the remnant thyroid tissue. The groups were examined and compared according to patients and tumor characteristics. The effect of the presence of residual tumor in remnant thyroid tissue on clinical course, disease-free survival, and overall survival were evaluated as well. RESULTS: After completion thyroidectomy, 20 (20.6%) of the 97 patients revealed additional cancer focus in the residual tissue. Median follow-up period was 104 months (range, 84-205 months). Only tumor multifocality in the resected lobe after first surgery was predictive of the presence of malignancy in the thyroid remnant (P = .002; relative risk, 4.9; 95% confidence interval, 1.7-14.5). Detection of malignancy in the remnant thyroid tissue did not affect the disease-free survival (P = .39). There were no deaths in patients who underwent reoperative thyroid surgery. CONCLUSIONS: Only tumor multifocality in the original thyroid lobe was predictive of finding additional cancer in the contralateral lobe. However, clinical significance of occult multifocal disease was not shown. Crown
PURPOSE: Total or near-total thyroidectomy is advocated in reducing the recurrence rate and improving survival in differentiated thyroid carcinoma. However, this potential benefit could be seen in all patient groups or only in the patients who have multifocal disease. We analyzed the clinical significance of occult multifocal disease in patients with completion thyroidectomy. PATIENTS AND METHODS: Ninety-seven patients in whom the completion thyroidectomy was performed within 6 months were included. The patients were grouped according to whether they have malignancy in the remnant thyroid tissue. The groups were examined and compared according to patients and tumor characteristics. The effect of the presence of residual tumor in remnant thyroid tissue on clinical course, disease-free survival, and overall survival were evaluated as well. RESULTS: After completion thyroidectomy, 20 (20.6%) of the 97 patients revealed additional cancer focus in the residual tissue. Median follow-up period was 104 months (range, 84-205 months). Only tumor multifocality in the resected lobe after first surgery was predictive of the presence of malignancy in the thyroid remnant (P = .002; relative risk, 4.9; 95% confidence interval, 1.7-14.5). Detection of malignancy in the remnant thyroid tissue did not affect the disease-free survival (P = .39). There were no deaths in patients who underwent reoperative thyroid surgery. CONCLUSIONS: Only tumor multifocality in the original thyroid lobe was predictive of finding additional cancer in the contralateral lobe. However, clinical significance of occult multifocal disease was not shown. Crown
Authors: Cho Rok Lee; Haiyoung Son; Sohee Lee; Sang-Wook Kang; Jong Ju Jeong; Kee-Hyun Nam; Woong Youn Chung; Cheong Soo Park Journal: World J Surg Date: 2014-04 Impact factor: 3.352
Authors: Lutske Lodewijk; Wouter P Kluijfhout; Jakob W Kist; Inge Stegeman; John T M Plukker; Els J Nieveen van Dijkum; H Jaap Bonjer; Nicole D Bouvy; Abbey Schepers; Johannes H W de Wilt; Romana T Netea-Maier; Jos A van der Hage; Jacobus W A Burger; Gavin Ho; Wayne S Lee; Wen T Shen; Anna Aronova; Rasa Zarnegar; Cassandre Benay; Elliot J Mitmaker; Mark S Sywak; Ahmad M Aniss; Schelto Kruijff; Benjamin James; Raymon H Grogan; Laurent Brunaud; Guillaume Hoch; Chiara Pandolfi; Daniel T Ruan; Michael D Jones; Marlon A Guerrero; Gerlof D Valk; Inne H M Borel Rinkes; Menno R Vriens Journal: Langenbecks Arch Surg Date: 2016-03-24 Impact factor: 3.445