The Cause of Cervical Lymph Node Recurrence after the Initial Surgery of Papillary Thyroid Carcinoma
10.21593/kjhno/2019.35.2.11
- Author:
Hyeung Kyoo KIM
1
;
Eun Ju HA
;
Inhwa LEE
;
Jeonghun LEE
;
Euy Young SOH
Author Information
1. Department of Surgery, Ajou University School of Medicine, Suwon, Korea. sohey@aumc.ac.kr
- Publication Type:Original Article
- Keywords:
Thyroid cancer papillary;
Recurrence;
Reoperation
- MeSH:
Cohort Studies;
Diagnosis;
Follow-Up Studies;
Humans;
Lymph Nodes;
Medical Records;
Neck;
Prognosis;
Recurrence;
Reoperation;
Retrospective Studies;
Thyroid Gland;
Thyroid Neoplasms;
Tomography, X-Ray Computed
- From:
Korean Journal of Head and Neck Oncology
2019;35(2):11-17
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/OBJECTIVES: Papillary thyroid carcinoma (PTC) has generally an indolent character with a good prognosis. However, recurrence remains a major concern for the patients during their lifetime. Despite the slowly progressing character of PTC, recurrence can occur within a short period after initial surgery.This study aimed to determine the clinical findings and cause of recurrence in patients who underwent re-operative surgery due to neck node recurrence by reviewing the CT (computed tomographic) scan imaging of the recurrence of PTC retrospectively.MATERIALS #SPCHAR_X0026; METHODS: We reviewed the medical records of patients referred to Ajou University Hospital from January 2002 to January 2018. All patients had re-operative surgery due to neck node recurrence and CT scan results of preoperative evaluation and postoperative follow up. Over this period, 110 patients who underwent re-operation due to neck node recurrence with a CT scan were included in our cohort, resulting in a total of 220 re-operations.RESULTS: The time from initial operation to first re-operation was examined in 110 patients. The median time to re-operation was 28 months, with a range of 4 months to 186 months. Most re-operations (82.7%) occurred within the first five years, 43.6% were in the first two years from the initial surgery. The result of the retrospective CT review showed newly developed cases (21,19.1%), missed diagnosis cases (42,38.2%), real recur cases after surgery (33,30.0%), and remnant lymph nodes (LNs) cases (14,12.7%). We further sub-analyzed 14 cases with remnant LNs. Reasons for remnant LNs included insufficient operation (N=5) and beyond general surgical extent. (N=9).CONCLUSION: Re-operation due to cervical lymph node recurrence is mostly a persistent disease. They included a missed diagnosis and incomplete operation. These finding may reduce the reoperation of cervical lymph node recurrence by accurate preoperative evaluation and complete surgical resection at the initial surgery.
