Factors Predicting Hypocalcemia after Total Thyroidectomy with Central Lymph Node Dissection in Papillary Thyroid Cancer.
10.16956/kjes.2015.15.3.60
- Author:
Ok Joo LEE
1
;
Hyung Chul KIM
;
Cheol Wan LIM
;
Eung Jin SHIN
;
Gyou Suk CHO
;
Jun Chul JUNG
;
Gui Ae JUNG
;
Zisun KIM
;
Jae Hong JEONG
;
Kyusung CHOI
;
Sun Wook HAN
;
Sung Mo HUR
Author Information
1. Department of Surgery, Bucheon Hospital, School of Medicine, Soonchunhyang University, Bucheon, Korea. smkine@gmail.com
- Publication Type:Original Article
- Keywords:
Thyroid cancer;
Total thyroidectomy;
Hypocalcemia;
Parathyroid hormone
- MeSH:
Calcium;
Humans;
Hypocalcemia*;
Logistic Models;
Lymph Node Excision*;
Lymph Nodes*;
Mass Screening;
Parathyroid Hormone;
Prospective Studies;
ROC Curve;
Sensitivity and Specificity;
Thyroid Gland*;
Thyroid Neoplasms*;
Thyroidectomy*;
Thyroiditis
- From:Korean Journal of Endocrine Surgery
2015;15(3):60-66
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Total thyroidectomy with central lymph node dissection (CLND) is a treatment modality of choice for thyroid cancer. Hypocalcemia is the most common complication after total thyroidectomy. The aim of the current study was to determine the association between surgery-related clinical factors and postoperative hypocalcemia. METHODS: A prospective analysis was performed for 101 patients who underwent total thyroidectomy with CLND for papillary cancer from June 2013 to June 2014. Correlation between clinicopathologic factors and postoperative hypocalcemia was analyzed. RESULTS: Based on the postoperative day-2 calcium, 56 patients (55%) developed hypocalcemia and 45 patients (45%) were normal. No significant differences in histopathologic (tumor size, tumor focality, histologic type, number of retrieved lymph nodes, metastatic lymph node, thyroiditis, retrieved parathyroid gland) findings were observed between the hypocalcemia group and normal calcium group. Mean value of the postoperative day-0 parathyroid hormone (PTH) was significantly lower in the hypocalcemia group (hypoca1cemia group: 14.3+/-9.4 pg/mL; normal group: 25.0+/-16.4 pg/mL; P<0.001). In logistic regression analysis, postoperative PTH was a factor significantly affecting postoperative hypocalcemia (OR 0.93; CI: 0.90-0.97; P<0.001). In ROC analysis, the cut-off value of PTH was 19.965 (sensitivity 79%, specificity 58%), and area under the curve (AUC) was 0.709 (95% CI: 0.607-0.811). CONCLUSION: Postoperative PTH was a factor predicting hypocalcemia after total thyroidectomy with CLND. Use of postoperative PTH as a screening tool for prediction of postoperative hypocalcemia would be useful in management of patients with hypocalcemia.
