scholarly journals Long-Term Efficacy of Lymph Node Reoperation for Persistent Papillary Thyroid Cancer

2010 ◽  
Vol 95 (5) ◽  
pp. 2187-2194 ◽  
Author(s):  
Osama Al-Saif ◽  
William B. Farrar ◽  
Mark Bloomston ◽  
Kyle Porter ◽  
Matthew D. Ringel ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Surgical Resection ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Initial Surgery ◽  
Retrospective Clinical Study

Abstract Objective: The objective of the study was to determine the outcome of surgical resection of metastatic papillary thyroid cancer (PTC) in cervical lymph nodes after failure of initial surgery and I131 therapy. Design: This was a retrospective clinical study. Setting: The study was conducted at a university-based tertiary cancer hospital. Patients: A cohort of 95 consecutive patients with recurrent/persistent PTC in the neck underwent initial reoperation during 1999–2005. All had previous thyroidectomy (±nodal dissection) and I131 therapy. Twenty-five patients with antithyroglobulin (Tg) antibodies were subsequently excluded. Main Outcome Measures: Biochemical complete remission (BCR) was stringently defined as undetectable TSH-stimulated serum Tg. Results: A total of 107 lymphadenectomies were undertaken in these 70 patients through January 2010. BCR was initially achieved in 12 patients (17%). Of the 58 patients with detectable postoperative Tg, 28 had a second reoperation and BCR was achieved in five (18%), seven had a third reoperation, and none achieved BCR. No patient achieving BCR had a subsequent recurrence after a mean follow-up of 60 months (range 4–116 months). In addition, two more patients achieved BCR during long-term follow-up without further intervention. In total, 19 patients (27%) achieved BCR and 32 patients (46%) achieved a TSH-stimulated Tg less than 2.0 ng/ml. Patients who did not achieve BCR had significant reduction in Tg after the first (P < 0.001) and second (P = 0.008) operations. No patient developed detectable distant metastases or died from PTC. Conclusions: Surgical resection of persistent PTC in cervical lymph nodes achieves BCR, when most stringently defined, in 27% of patients, sometimes requiring several surgeries. No biochemical or clinical recurrences occurred during follow-up. In patients who do not achieve BCR, Tg levels were significantly reduced. The long-term durability and impact of this intervention will require further investigation.

scholarly journals Relationship between focality and cervical lymph nodes metastasis in papillary thyroid carcinoma

2019 ◽  
Vol 6 (2) ◽  
pp. 453
Author(s):  
Tarek M. Rageh ◽  
Rehab M. Samaka ◽  
Mahmoud G. Hagag ◽  
Elsayed A. Motawa
Keyword(s):  
Thyroid Cancer ◽  
High Risk ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
High Rate ◽  
Capsular Invasion ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Cancer Management

Background: Papillary Thyroid Cancer (PTC) is the most common malignancy in thyroid gland and may be unifocal or multifocal. This study compares between unifocal and multifocal PTC to clarify which type has an aggressive behaviour.Methods: This retrospective and prospective cross-sectional study was done on one hundred PTC patients who underwent papillary thyroid cancer management. The unifocal and multifocal groups each one contains 50 patients. The study was done in the period between January 2015 to January 2018. Other types of cancer thyroid and distant metastatic thyroid cancer were excluded from the study. All patients underwent follow up for one year.Results: There are significant differences between unifocal and multifocal PTC regarding to age, the number of positive lymph nodes, history of multinodular goiter (MNG) and capsular invasion. The capsular invasion in multifocal increase the recurrence rate (P=0.03).Conclusions: The new proposed method for PTC tumor size assessment could be a valuable in multifocal PTC patient’s stratification into low risk and high-risk subgroups. Therefore, high risk multifocal PTC patients could have a poor prognosis and high rate of recurrence, for that require aggressive treatment and strict follow up.

Abstract 730: Annual hazard rate of recurrence in Middle-Eastern papillary thyroid cancer over a long-term follow-up

2021 ◽  
Author(s):  
Abdul K. Siraj ◽  
Sandeep K. Parvathareddy ◽  
Zeeshan Qadri ◽  
Saud Azam ◽  
Felisa De Vera ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Hazard Rate ◽  
Middle Eastern ◽  
Papillary Thyroid ◽  
Long Term Follow Up

scholarly journals Thyroglobulin measurements in washout of fine needle aspirates in cervical lymph nodes for detection of papillary thyroid cancer metastases

2010 ◽  
Vol 54 (6) ◽  
pp. 550-554 ◽  
Author(s):  
André B. Zanella ◽  
Erika L. Souza Meyer ◽  
Letícia Balzan ◽  
Antônio C. Silva ◽  
Joíza Camargo ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Cancer Metastases ◽  
Thyroid Cancer Metastases

OBJECTIVE: The aim of this study was to evaluate the accuracy of the measurement of thyroglobulin in washout needle aspiration biopsy (FNAB-Tg) to detect papillary thyroid cancer (PTC) metastases. SUBJECTS AND METHODS: Forty-three patients (51.4 ± 14.6 years) with PTC diagnosis and evidence of enlarged cervical lymph nodes (LN) were included. An ultrasound-guided fine-needle aspiration of suspicious LN was performed, for both cytological examination and measurement of FNAB-Tg. RESULTS: The median values of FNAB-Tg in patients with metastatic LN (n = 5) was 3,419 ng/mL (11.1-25,538), while patients without LN metastasis (n = 38) showed levels of 3.7 ng/mL (0.8-7.4). Considering a 10 ng/mL cutoff value for FNAB-Tg, the sensitivity and specificity was 100%. There were no differences on the median of FNAB-Tg measurements between those on (TSH 0.07 mUI/mL) or off levothyroxine (TSH 97.4 mUI/mL) therapy (3.3 vs. 3.8 ng/mL, respectively; P = 0.2). CONCLUSION: The results show that evaluation of FNAB-Tg in cervical LN is a valuable diagnostic tool for PTC metastases that can be used independent of the thyroid status.

scholarly journals The association between tumor’s location and cervical lymph nodes metastasis in papillary thyroid cancer

Gland Surgery ◽  
2019 ◽  
Vol 8 (5) ◽  
pp. 557-568 ◽  
Author(s):  
Ting-Ting Zhang ◽  
Xiu-Zhu Qi ◽  
Jian-Ping Chen ◽  
Rong-Liang Shi ◽  
Shi-Shuai Wen ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Lymph Nodes Metastasis

scholarly journals Elastography as a Potential Modality for Screening Cervical Lymph Nodes in Patients with Papillary Thyroid Cancer: A Review of Literature

2018 ◽  
Vol 97 (1-2) ◽  
pp. 31-39 ◽  
Author(s):  
Robert Saadi ◽  
Salvatore LaRusso ◽  
Kanupriya Vijay ◽  
David Goldenberg
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Clinical Utility ◽  
Lymph Node Involvement ◽  
Papillary Thyroid ◽  
Ultrasound Technique ◽  
Cervical Lymph Nodes ◽  
Specific Patient ◽  
Clinical Criteria

Papillary thyroid cancer often presents with cervical lymph node involvement and has a high incidence of recurrence, which requires routine follow-up with ultrasound imaging. Elastography is a novel ultrasound technique that has been demonstrated to be effective clinically in detecting tissue pathology in areas such as the liver and breast. Preliminary data suggest that it may be effective in screening tissues in the neck for malignancy, specifically cervical lymph nodes. However, diagnostic criteria and elastographic techniques vary significantly among the studies we have reviewed, which all tend to focus on populations of patients with many different types of primary malignancies. Further research is required on the feasibility of creating standardized and reproducible clinical criteria in a specific patient population. To study the clinical utility of elastography in cervical lymph nodes, patients with diagnosed papillary thyroid carcinoma may serve as an ideal population because of their need for ultrasound surveillance and the propensity of papillary thyroid cancer to metastasize to and recur in cervical lymph nodes. We will review the limitations, techniques, and reported clinical utility of elastography on cervical lymph nodes and its potential as a screening modality for papillary thyroid cancer.

scholarly journals Suspicious Cervical Lymph Nodes Detected after Thyroidectomy for Papillary Thyroid Cancer Usually Remain Stable Over Years in Properly Selected Patients

2012 ◽  
Vol 97 (8) ◽  
pp. 2706-2713 ◽  
Author(s):  
E. Robenshtok ◽  
S. Fish ◽  
A. Bach ◽  
Jose M. Domínguez ◽  
A. Shaha ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Active Surveillance ◽  
Regional Recurrence ◽  
Lateral Neck ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Value Range ◽  
Almost All

Abstract Context: The risk of loco-regional recurrence in papillary thyroid cancer (PTC) patients ranges from 15–30%. However, the clinical significance of small-volume loco-regional recurrence detected by highly sensitive ultrasonography is unclear. Objective: Our objective was to describe the natural history of abnormal cervical lymph nodes (LN) diagnosed after initial treatment. Design: We conducted a retrospective cohort study. Patients: 166 PTC with patients who had at least one abnormal LN outside the thyroid be on ultrasound and selected for active surveillance were included. Main Outcome Measure: LN growth during a period of active surveillance was the primary outcome. Results: Most patients had classical PTC (85%) and an intermediate risk of recurrence (77%). The median LN size at the start of the observation period was 1.3 cm (range, 0.5–2.7 cm) in largest diameter, with all nodes having at least one abnormal sonographic characteristic (70% of patients had LN with at least two abnormal features). In almost all patients, the LN were in the lateral neck, primarily in levels 3 (43%) and 4 (58%). After a median follow-up of 3.5 yr, only 20% (33 of 166) grew at least 3 mm, 9% (15 of 166) grew at least 5 mm, and 14% (23 of 166) resolved. None of the clinical or sonographic features were predictive of LN growth (positive predictive value range = 0.21–0.57). There were no local complications (nerve damage or local invasion) related to the abnormal nodes and no disease-related mortality. Conclusions: Suspicious cervical LN in the lateral neck usually remain stable for long periods of time in properly selected PTC patients and can be safely followed with serial ultrasounds

scholarly journals Utility of Surgeon-Performed Ultrasound Assessment of the Lateral Neck for Metastatic Papillary Thyroid Cancer

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Cortney Y. Lee ◽  
Samuel K. Snyder ◽  
Terry C. Lairmore ◽  
Sean C. Dupont ◽  
Daniel C. Jupiter
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Metastatic Disease ◽  
Needle Aspiration ◽  
Lateral Neck ◽  
Papillary Thyroid ◽  
Imaging Studies ◽  
Cervical Lymph Nodes ◽  
Ultrasound Assessment

Ultrasound is the recommended staging modality for papillary thyroid cancer. Surgeons proficient in US assessment of the neck and experienced in the management of papillary thyroid cancer (PTC) appear uniquely qualified to assess the lateral cervical lymph nodes for metastatic disease. Of 310 patients treated for PTC between 2000 and 2008, 109 underwent surgeon-performed ultrasound (SUS) of the lateral neck preoperatively. Fine needle aspiration was performed on suspicious lateral lymph nodes. SUS findings were compared with FNA cytology and results of postoperative imaging studies. The sensitivity and negative predictive value of SUS were 88% and 97%, respectively. Four patients were found to have missed metastatic disease within 6 months. No patient underwent a nontherapeutic neck dissection. SUS combined with US-guided FNA of suspicious lymph nodes can accurately stage PTC to reliably direct surgical management.

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