Preoperative neck ultrasonographic mapping for persistent/recurrent papillary thyroid cancer

Area of Science:

• Oncology
• Surgical Oncology
• Radiology

Background:

• Surgical resection is recommended for persistent/recurrent (P/R) papillary thyroid cancer (PTC) localized to the neck.
• The impact of surgical resection on the disease course of P/R PTC is not fully understood.
• Novel techniques are needed to improve surgical outcomes for P/R PTC.

Purpose of the Study:

• To evaluate the efficacy of a new technique, preoperative neck ultrasonographic mapping (US-M), in improving surgical resection outcomes for P/R PTC.
• To compare the surgical outcomes of P/R PTC patients treated with US-M-guided resection versus conventional neck dissection.

Main Methods:

• A retrospective study comparing two groups of P/R PTC patients undergoing neck dissection.
• Group 1 (G1) underwent conventional neck dissection (n=19).
• Group 2 (G2) underwent limited lymph node resection guided by preoperative US-M (n=26), with findings plotted on a diagram. All surgeries performed by a single surgeon.

Main Results:

• Postoperative neck ultrasound became negative in 83.3% of G2 patients versus 50% in G1 (p=0.02).
• Remission rates were significantly higher in G2 (62.5%) compared to G1 (31.6%) after a mean follow-up of 9.8 months and 23.8 months, respectively (p=0.04).
• Intraoperative findings matched US-M in 88.5% of G2 patients.

Conclusions:

• Preoperative neck ultrasonographic mapping (US-M) is an effective technique for improving surgical outcomes in P/R PTC.
• US-M-guided resection leads to better postoperative imaging results and a higher rate of disease remission.
• This technique enhances the precision of surgical resection for recurrent thyroid cancer.