The outcomes and prognostic factors of patients who underwent reoperation for persistent/recurrent papillary thyroid carcinoma

BMC Surgery

卷:22

Research

Lili Chen¹  Duanshu Li¹  Yi Wu¹  Jun Xiang¹  Tuanqi Sun¹  Wenyu Sun²  Lu Di³  Shichong Zhou⁴ 

[1] Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, No. 270, Dong’an Road, 200032, Shanghai, China;Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, China;

[2] Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, No. 270, Dong’an Road, 200032, Shanghai, China;Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, China;Department of Ultrasound, Fudan University Shanghai Cancer Center, No. 270, Dong’an Road, 200032, Shanghai, China;

[3] Department of Internal Medicine, Wusong Hospital, Zhongshan Hospital, Fudan University, Shanghai, China;

[4] Department of Ultrasound, Fudan University Shanghai Cancer Center, No. 270, Dong’an Road, 200032, Shanghai, China;

关键词: Reoperation;    Radioiodine therapy;    Papillary thyroid carcinoma;    Recurrence;   

DOI  :  10.1186/s12893-022-01819-1

 received in 2022-07-12, accepted in 2022-10-14,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundWhile the most suitable approach for treating persistent/recurrent papillary thyroid carcinoma (PTC) remains controversial, reoperation may be considered an effective method. The efficacy of reoperation in patients with locoregional persistent/recurrent PTC, especially those with unsatisfactory radioactive iodine (RAI) ablation results, is still uncertain. This study aimed to clarify the clinical management strategies for locoregional persistent/recurrent PTC and to explore factors that may affect long-term patient outcomes after reoperation.MethodsIn total, 124 patients who initially underwent thyroidectomy and variable extents of RAI therapy and finally received reoperation for locoregionally persistent/recurrent PTC were included. The parameters associated with recurrence-free survival (RFS) were analysed using a Cox proportional hazards model.ResultsOverall, 124 patients presented with structural disease after initial therapy and underwent secondary surgical resection, of whom 32 patients developed further structural disease during follow-up after reoperation. At the time of reoperation, metastatic lymph nodes with extranodal extension (P = 0.023) and high unstimulated thyroglobulin (unstim-Tg) levels after reoperation (post-reop) (P = 0.001) were independent prognostic factors for RFS. Neither RAI avidity nor the frequency and dose of RAI therapies before reoperation affected RFS.ConclusionsReoperation is an ideal clinical treatment strategy for structural locoregional persistent/recurrent PTC, and repeated empirical RAI therapies performed prior to reoperation may not contribute to the long-term outcomes of persistent/recurrent PTC patients. Metastatic lymph nodes with extranodal extension and post-reop unstim-Tg > 10.1 ng/mL may predict a poor prognosis.

【 授权许可】

CC BY   
© The Author(s) 2022

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