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Long-term efficacy of lymph node reoperation for persistent papillary thyroid cancer
Osama Al-Saif1, William B Farrar, Mark Bloomston
1Department of Surgery, The Ohio State University, Columbus, Ohio 43210, USA.
The Journal of Clinical Endocrinology and Metabolism
|March 25, 2010
Summary
Surgical resection of persistent papillary thyroid cancer (PTC) in lymph nodes can achieve biochemical complete remission in 27% of patients. This intervention significantly reduces thyroglobulin (Tg) levels, with no recurrences observed during follow-up.
Area of Science:
- Oncology
- Surgical Oncology
- Endocrinology
Background:
- Papillary thyroid cancer (PTC) can metastasize to cervical lymph nodes.
- Treatment failure after initial surgery and radioactive iodine (I(131)) therapy necessitates further intervention.
- Recurrent or persistent PTC in the neck requires evaluation of salvage treatment options.
Purpose of the Study:
- To assess the efficacy of surgical resection for metastatic PTC in cervical lymph nodes.
- To determine the rate of biochemical complete remission (BCR) after reoperation.
- To evaluate the long-term outcomes and recurrence rates following surgical intervention.
Main Methods:
- Retrospective clinical study at a tertiary cancer hospital.
- Included 70 patients with recurrent/persistent PTC undergoing reoperation between 1999-2005.
- Defined BCR as undetectable TSH-stimulated serum thyroglobulin (Tg).
Main Results:
- 107 lymphadenectomies were performed; 27% of patients achieved BCR.
- Multiple reoperations were sometimes required to achieve BCR.
- Patients not achieving BCR showed significant Tg reduction; no distant metastases or PTC-related deaths occurred.
Conclusions:
- Surgical resection is a viable option for persistent cervical PTC, achieving BCR in 27% of cases.
- The intervention leads to significant Tg reduction and durable remission in responders.
- Further studies are needed to confirm long-term outcomes and the impact of this approach.
