Clinical analysis of reoperation for recurrent/persistent papillary thyroid carcinoma
10.3760/cma.j.cn.115807-20230513-00141
- VernacularTitle:甲状腺乳头状癌复发及持续状态再次手术临床分析
- Author:
Chang DENG
1
;
Zhixin YANG
;
Xinliang SU
Author Information
1. 重庆理工大学附属中心医院肝胆甲乳血管外科，重庆 400054
- Keywords:
Papillary thyroid carcinoma;
Lymph node metastasis;
Recurrent laryngeal nerve;
Recurrence or persistence state;
Reoperation
- From:
Chinese Journal of Endocrine Surgery
2023;17(6):724-728
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the causes of reoperation for papillary thyroid carcinoma (PTC) and summarize experience to reduce avoidable reoperations.Methods:We retrospectively studied 60 patients with PTC who underwent reoperation in the Department of Breast and Thyroid Surgery of the First Affiliated Hospital of Chongqing Medical University from Jan. 2013 to Dec. 2017. Through the clinical description of the recurrence of tumors in different regions and the differences between the recurrence of reoperation and Clinical characteristics, the cause of the reoperation and the risk of recurrence are analyzed.Results:Of the 60 PTC patients included in this study, 11 (18.3%) had lymph node metastasis (LNM) in the central plus lateral compartment of the affected side; 34 (56.7%) only had lymph node metastasis of the affected side compartment; There were 6 (10.0%) metastasis to the lymph node posterior to right recurrent laryngeal nerve (LN-prRLN) ; 10 (16.7%) patients had lymph node metastases in the contralateral compartment; We found that patients with recurrence after reoperation were older ( P=0.003) , the more number of lymph node metastases (LNMN) ( P=0.037) , and with higher level of thyroglobulin than that before reoperation ( P=0.034) ; and multivariate analysis indicated that LNMN in initial operation ( OR=1.174, P=0.008) , age ( OR=1.130, P=0.014) and Tg level before reoperation ( OR=1.156, P=0.040) were all independent predictors for recurrence after reoperation. Conclusions:Local lymph nodes recurrence/persistence is the main reason for reoperation in our study. LNM of the initial operation and age affect the prognosis after reoperation. Reoperation is difficult and risky, and attention should be paid to the protection of parathyroid glands and recurrent laryngeal nerve by nerve monitoring and frozen biopsy.
