Efficacy of nodal dissection for treatment of persistent/recurrent papillary thyroid cancer

The Laryngoscope
Kathryn G SchuffJames I Cohen

Abstract

Although commonly performed, data are lacking regarding efficacy and safety of lymph node dissection (LND) for recurrent/persistent papillary thyroid cancer (PTC). Evaluate the efficacy and morbidity of LND in recurrent/persistent PTC. Retrospective review of central or lateral LND performed for persistent/recurrent PTC between January 2004 and March 2006. Multidisciplinary thyroid cancer clinic with a single surgeon at an academic medical center. Seventy-five patients who underwent 79 LND for persistent/residual PTC. Safety analysis included all 79 resections. Exclusion criteria for the efficacy analysis were factors prohibiting evaluation of thyroglobulin (Tg) response. Forty-one resections were included in the efficacy analysis. Selective LND per standard of care. Primary outcome was the Tg response to LND. Secondary outcomes were surgical complications. Thirty-nine of the 41 evaluable resections also had Tg data allowing classification of Tg response. Of 39 classifiable resections, 16 (41%) resulted in undetectable postoperative stimulated Tg levels. An additional 12 resections resulted in significant (> or =50%) reductions in suppressed or stimulated Tg levels for an overall improvement rate of 72%. Of all 79 resections, 2...Continue Reading

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