Clinical features and prognoses of re-operated patients for persistent/recurrent papillary thyroid carcinoma.
10.3760/cma.j.cn115330-20211231-00842
- Author:
Nan XU
1
;
Yong Cong CAI
2
;
Rong Hao SUN
2
;
Bin Tao HU
3
;
Lei LIU
2
;
Yu Qing XIANG
3
;
Wang Hu ZHENG
1
;
Xiao Lei CHEN
1
;
Gang QIN
4
;
Xu WANG
2
;
Chun Yan SHUI
2
;
Yu Dong NING
2
;
Yu Qiu ZHOU
2
;
Chao LI
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Institute of Cancer Research, Sichuan Cancer Prevention and Control Center, Cancer Hospital Affiliate to School of Medicine, Electronic Science and Technology, Chengdu 610041, China.
2. Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Institute of Cancer Research, Sichuan Cancer Prevention and Control Center, Cancer Hospital Affiliate to School of Medicine, Electronic Science and Technology, Chengdu 610041, China.
3. Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Institute of Cancer Research, Sichuan Cancer Prevention and Control Center, Cancer Hospital Affiliate to School of Medicine, Electronic Science and Technology, Chengdu 610041, China Department of Clinical Medicine, Chengdu Medical College, Chengdu 610500, China.
4. Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.
- Publication Type:Journal Article
- MeSH:
Adult;
Carcinoma/pathology*;
Carcinoma, Papillary/surgery*;
Female;
Humans;
Lymphatic Metastasis;
Male;
Middle Aged;
Neck Dissection;
Neoplasm Recurrence, Local/surgery*;
Prognosis;
Retrospective Studies;
Thyroid Cancer, Papillary/surgery*;
Thyroid Neoplasms/pathology*;
Thyroidectomy/adverse effects*
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2022;57(9):1052-1058
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the clinicopathological characteristics and the survival of re-operated patients for persistent/recurrent papillary thyroid carcinoma (PTC) and risk factors for re-recurrence after the second operation. Method: A retrospective analysis of 69 cases underwent re-operation for persistent/recurrent PTC in Sichuan Cancer Hospital from January 2010 to December 2016 was performed. There were 21 males and 48 females, aged 14-85 (44.8) years old. According to the imaging after initial treatment, they were divided into a recurrence group (42 cases) and a persistent disease/residual group (27 cases). The positive rates of ipsilateral paratracheal lymph node metastases at re-operation were calculated and compared by chi-square test. Patients were divided into different subgroups according to potential risk factors for re-recurrence. Kaplan-Meier (K-M) method was used for survival analysis. Results: The positive rate of ipsilateral paratracheal lymph node metastasis in recurrence group (15/42, 35.7%) was significantly lower than that in the persistent disease/residual group (17/27, 63.0%) (χ2=4.91, P<0.05). The follow-up period after re-operation was 60-104 months, with a median of 66 months, and 8 patients were lost to follow-up. Permanent hypoparathyroidism occurred in 2 cases (2.9%) and permanent recurrent laryngeal nerve palsy in 1 case (1.4%). Twenty patients had structural recurrences and/or distant metastases. The 5-year disease-specific survival rate was 92.8% and the 5-year recurrence-free survival rate was 68.1%. Survival analysis was performed on risk factors such as age≥55 years old, recurrent tumor diameter ≥4 cm, number of positive lymph nodes ≥ 10, and obvious extracapsular invasion (ENE). Among them, age and diameter of recurrent tumor had significant influences on recurrence-free survival rate (χ2 was 6.36, 8.17, respectively, both P values<0.05). There was a statistically significant difference in recurrence-free survival rates between ENE(+) group and ENE(-) group (χ2=5.52, P<0.05). Conclusion: For the re-operated patients due to persistence/ recurrence PTC, attention should be paid to protecting the parathyroid gland and recurrent laryngeal nerve during re-operation. Timely and effective postoperative follow-up for patients aged ≥ 55 years, with recurrent tumor diameter ≥ 4 cm and ENE(+), can significantly improve their prognoses.
