BACKGROUND: The influence of lymph node recurrences of papillary thyroid carcinoma (PTC) on overall prognosis is uncertain. We performed a population-based, longitudinal analysis to evaluate the impact of reoperation on mortality. METHODS: Patients who underwent initial operation for PTC >1 cm were abstracted from the California Cancer Registry database (1999-2008). Reoperation was defined as any lymph node dissection after total or near-total thyroidectomy. RESULTS: Of the 11,986 patients included in the study, 222 (1.9%) underwent one or more reoperations. The median time to reoperation was 8.7 months, with 58.6% and 83.8% of reoperations being performed within 1 and 2 years of initial thyroidectomy, respectively. The mortality rate from PTC was 2.3% (271 patients). After we adjusted for age, sex, tumor size, stage, and radioactive iodine treatment, we found that reoperation was associated with an increased risk of all-cause mortality in patients ≥45 years of age (hazard ratio [HR] 1.51, P < .05). Reoperation was associated with an increased risk of disease-specific mortality in both patients <45 (HR 6.22, P < .01) and ≥45 (HR 2.49, P < .001). CONCLUSION: Reoperation is independently associated with mortality in PTC. Most reoperations are performed soon after initial thyroidectomy and likely reflect persistent rather than recurrent disease.
BACKGROUND: The influence of lymph node recurrences of papillary thyroid carcinoma (PTC) on overall prognosis is uncertain. We performed a population-based, longitudinal analysis to evaluate the impact of reoperation on mortality. METHODS:Patients who underwent initial operation for PTC >1 cm were abstracted from the California Cancer Registry database (1999-2008). Reoperation was defined as any lymph node dissection after total or near-total thyroidectomy. RESULTS: Of the 11,986 patients included in the study, 222 (1.9%) underwent one or more reoperations. The median time to reoperation was 8.7 months, with 58.6% and 83.8% of reoperations being performed within 1 and 2 years of initial thyroidectomy, respectively. The mortality rate from PTC was 2.3% (271 patients). After we adjusted for age, sex, tumor size, stage, and radioactive iodine treatment, we found that reoperation was associated with an increased risk of all-cause mortality in patients ≥45 years of age (hazard ratio [HR] 1.51, P < .05). Reoperation was associated with an increased risk of disease-specific mortality in both patients <45 (HR 6.22, P < .01) and ≥45 (HR 2.49, P < .001). CONCLUSION: Reoperation is independently associated with mortality in PTC. Most reoperations are performed soon after initial thyroidectomy and likely reflect persistent rather than recurrent disease.
Authors: Iain J Nixon; Laura Y Wang; Jocelyn C Migliacci; Antoine Eskander; Michael J Campbell; Ahmad Aniss; Lilah Morris; Fernanda Vaisman; Rossana Corbo; Denise Momesso; Mario Vaisman; Andre Carvalho; Diana Learoyd; William D Leslie; Richard W Nason; Deborah Kuk; Volkert Wreesmann; Luc Morris; Frank L Palmer; Ian Ganly; Snehal G Patel; Bhuvanesh Singh; R Michael Tuttle; Ashok R Shaha; Mithat Gönen; K Alok Pathak; Wen T Shen; Mark Sywak; Luis Kowalski; Jeremy Freeman; Nancy Perrier; Jatin P Shah Journal: Thyroid Date: 2016-02-25 Impact factor: 6.568
Authors: Laura Y Wang; Frank L Palmer; Jocelyn C Migliacci; Iain J Nixon; Ashok R Shaha; Jatin P Shah; Robert Michael Tuttle; Snehal G Patel; Ian Ganly Journal: Clin Endocrinol (Oxf) Date: 2015-07-03 Impact factor: 3.478
Authors: I J Nixon; L Y Wang; I Ganly; S G Patel; L G Morris; J C Migliacci; R M Tuttle; J P Shah; A R Shaha Journal: Br J Surg Date: 2015-10-29 Impact factor: 6.939
Authors: Manish A Shaha; Laura Y Wang; Jocelyn C Migliacci; Frank L Palmer; Iain J Nixon; R Michael Tuttle; Ashok R Shaha; Jatin P Shah; Snehal G Patel; Ian Ganly Journal: Thyroid Date: 2017-02-16 Impact factor: 6.568
Authors: Laura Y Wang; Jocelyn C Migliacci; R Michael Tuttle; Ashok R Shaha; Jatin P Shah; Snehal G Patel; Ian Ganly Journal: Clin Endocrinol (Oxf) Date: 2017-06-14 Impact factor: 3.478
Authors: Laura Y Wang; Benjamin R Roman; Jocelyn C Migliacci; Frank L Palmer; R Michael Tuttle; Ashok R Shaha; Jatin P Shah; Snehal G Patel; Ian Ganly Journal: Cancer Date: 2015-08-17 Impact factor: 6.860