Analysis of Risk Factors Contributing to Recurrence of Papillary Thyroid Carcinoma in Chinese Patients Who Underwent Total Thyroidectomy

Objective: The aim of this study was to explore the effect of total thyroidectomy (TT) and lobectomy (LT) on the prognosis of unilateral papillary thyroid carcinoma (PTC) with lateral cervical lymph node metastasis. Methods: Patients with PTC and lateral cervical lymph node metastasis who underwent lateral cervical lymph node dissection between January 2007 and December 2016 were retrospectively reviewed. To investigate the effect of surgical procedure on the prognosis of lymph node metastasis patients, other high-risk factors such as extrathyroidal invasion and large tumor size were excluded. All patients were in Tumor-Node-Metastasis (TNM) stage T1 and T2. Primary end point was recurrence-free survival (RFS). Results: Among 264 PTC patients, 104 (39.4%) patients received TT and 160 (60.6%) patients received LT. With a median follow-up of 50 months (interquartile range, 34 to 74 months), 7 patients (2.65%) experienced recurrence. The 5-year RFS in the TT and LT groups was 96.1% and 97.7%, respectively, and was not significantly different ( P = .765). Similar results were found when excluding patients who received radioiodine ablation, which were 97.7% and 97.4%, respectively ( P = .752). Age ≥55 years (hazard ratio, 7.368; P = .018) and multifocality in the ispi-lateral lobe (hazard ratio, 10.059; P =.006) were identified as independent risk factors of recurrence. Conclusion: For unilateral TNM T1 and T2 PTC patients with lateral lymph node metastasis, there was no significant difference in the effect of TT and LT for RFS in the absence of other risk factors during the follow-up period. Patient age ≥55 years with multifocality in the unilateral lobe might be independent risk factors for prognosis. Abbreviations: ATA = American Thyroid Association; CT = computed tomography; ETE = extrathyroidal extension; LT = lobectomy; L-T4 = levothyroxine; PTC = papillary thyroid carcinoma; RFS = recurrence-free survival; RIA = radioiodine ablation; TgAb = anti-thyroglobulin antibody; TT = total thyroidectomy; TNM = Tumor-Node-Metastasis

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INCIDENCE, RISK FACTORS, AND CLINICAL IMPLICATIONS OF DELAYED HYPOPARATHYROIDISM ON POSTOPERATIVE DAY TWO FOLLOWING TOTAL THYROIDECTOMY FOR PAPILLARY THYROID CARCINOMA

Endocrine Practice ◽

10.4158/ep-2019-0544 ◽

2020 ◽

Vol 26 (7) ◽

pp. 768-776

Author(s):

Seung Taek Lim ◽

Ye Won Jeon ◽

Hongki Gwak ◽

Young Jin Suh

Keyword(s):

Risk Factors ◽

Parathyroid Hormone ◽

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Total Thyroidectomy ◽

Significant Risk ◽

Clinical Implications ◽

Intact Parathyroid Hormone ◽

Permanent Hypoparathyroidism ◽

Papillary Thyroid

Objective: This study aimed to investigate the incidence rates, risk factors, and clinical implications of delayed hypoparathyroidism on postoperative day 2 (POD-2) after total thyroidectomy in patients with papillary thyroid carcinoma. Methods: This study included 410 patients with normal serum intact parathyroid hormone (iPTH) and calcium levels on postoperative day 1 (POD-1) who were classified into 2 groups according to the presence or absence of delayed hypoparathyroidism on POD-2. Results: Of the 410 patients, 98 experienced delayed hypoparathyroidism on POD-2 (23.9%). The significant risk factors for delayed hypoparathyroidism on POD-2 included female gender, age older than 45 years, central lymph node dissection, increased number of excised lymph nodes, and low POD-1 versus preoperative iPTH ratios. Additionally, delayed hypoparathyroidism on POD-2 was found to be a significant risk factor for hypocalcemia on POD-2 and permanent hypoparathyroidism. Conclusion: Prophylactic calcium supplementation and long-term surveillance for permanent hypoparathyroidism should be considered in patients with risk factors for delayed hypoparathyroidism on POD-2. Abbreviations: CI = confidence interval; iPTH = intact parathyroid hormone; OR = odds ratio; POD-1 = postoperative day 1; POD-2 = postoperative day 2; PTC = papillary thyroid carcinoma; ROC = receiver operating characteristic

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Risk Factors of Postoperative Hypocalcemia after Total Thyroidectomy of Papillary Thyroid Carcinoma Patients

The Korean Journal of Endocrine Surgery ◽

10.16956/kjes.2016.16.3.70 ◽

2016 ◽

Vol 16 (3) ◽

pp. 70 ◽

Cited By ~ 1

Author(s):

Ji Young Seong ◽

Cho Rok Lee ◽

Min Jhi Kim ◽

Tae Hyung Kim ◽

Seul Gi Lee ◽

...

Keyword(s):

Risk Factors ◽

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Total Thyroidectomy ◽

Papillary Thyroid ◽

Postoperative Hypocalcemia

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Predictors of thyroglobulin in the lymph nodes recurrence of papillary thyroid carcinoma undergoing total thyroidectomy

BMC Surgery ◽

10.1186/s12893-021-01063-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhichao Xing ◽

Yuxuan Qiu ◽

Zhe Li ◽

Lingyun Zhang ◽

Yuan Fei ◽

...

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Lymph Nodes ◽

Total Thyroidectomy ◽

Radioactive Iodine ◽

Independent Predictor ◽

Central Neck Dissection ◽

American Thyroid Association ◽

Papillary Thyroid ◽

Serum Thyroglobulin

Abstract Background To investigate the association between postoperative lymph nodes (LNs) recurrence and distinct serum thyroglobulin (Tg) levels in patients with papillary thyroid carcinoma (PTC). Methods This study included PTC patients who underwent total thyroidectomy (TT) with at least central neck dissection and then re-operated due to recurrence of LNs between January 2013 and June 2018. These patients were grouped by negative or positive serum Tg levels according to the American Thyroid Association guidelines. Results Of the 60 included patients, 49 underwent radioactive iodine (RAI) treatment. Maximum unstimulated Tg (uTg) ≥ 0.2 ng/mL were associated with larger diameter of recurrent LNs (P = 0.027), and higher rate of metastatic LNs (P < 0.001). Serum-stimulated Tg (off-Tg) ≥ 1 ng/mL (P = 0.047) and unstimulated Tg (on-Tg) ≥ 0.2 ng/Ml (P = 0.013) were associated with larger diameter of recurrent LNs. Number of metastatic LNs ≥ 8 was an independent predictor for postoperative maximum uTg ≥ 0.2 ng/mL (OR = 8.767; 95% CI = 1.392–55.216; P = 0.021). Ratio of metastatic LNs ≥ 25% was an independent predictor for off-Tg ≥ 1 ng/mL (OR = 20.997; 95% CI = 1.649–267.384; P = 0.019). Conclusion Postoperative Tg-positive status was associated with larger size of recurrent LNs. Number of metastatic LNs ≥ 8 and ratio of metastatic LNs ≥ 25% were independent predicators for uTg-positive and off-Tg-positive status, respectively.

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