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Predictors of recurrence after total thyroidectomy plus neck dissection and radioactive iodine ablation for high-risk papillary thyroid carcinoma.
J Surg Oncol. 2020 Jun 25 [Online ahead of print]JS

Abstract

BACKGROUND

American Thyroid Association (ATA) proposed management guidelines for differentiated thyroid cancer, including a three-tiered risk stratification system for structural recurrence. This study aimed to compare the various 2015 ATA criteria for the strength of association with the recurrence of high-risk papillary thyroid carcinoma (PTC).

STUDY DESIGN

This study included 545 consecutive patients who underwent total thyroidectomy plus neck dissection and radioactive iodine ablation (RAI) for previously untreated high-risk PTC. The association of recurrence-free survival (RFS) with clinicopathological factors was evaluated by univariate and multivariate Cox proportional hazard regression analyses.

RESULTS

During a follow-up median period of 89 months, 90 (16.5%) patients had any-site recurrence. Of the high-risk factors, high stimulated thyroglobulin (sTg) level and >3-cm sized lymph nodes (LNs) were significantly associated with recurrence (all P < .005). Sex, tumor size, lymphovascular invasion, multifocality, number of positive LNs, extranodal extension, T and N classifications, and overall tumor-node-metastasis stage were also significantly associated with recurrence (all P < .05). In multivariate analyses, high sTg level [adjusted hazard ratio (HR) = 7.18] and N1b (adjusted HR = 3.27) were independent factors predictive of recurrence (all P ≤ .001).

CONCLUSIONS

Postoperative high serum sTg level might be the most important predictor of PTC recurrence after total thyroidectomy plus neck dissection and RAI.

Authors+Show Affiliations

Departments of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.Departments of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.Departments of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.Departments of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.Departments of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.Departments of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32588461

Citation

Kim, Yonghan, et al. "Predictors of Recurrence After Total Thyroidectomy Plus Neck Dissection and Radioactive Iodine Ablation for High-risk Papillary Thyroid Carcinoma." Journal of Surgical Oncology, 2020.
Kim Y, Roh JL, Song D, et al. Predictors of recurrence after total thyroidectomy plus neck dissection and radioactive iodine ablation for high-risk papillary thyroid carcinoma. J Surg Oncol. 2020.
Kim, Y., Roh, J. L., Song, D., Cho, K. J., Choi, S. H., Nam, S. Y., & Kim, S. Y. (2020). Predictors of recurrence after total thyroidectomy plus neck dissection and radioactive iodine ablation for high-risk papillary thyroid carcinoma. Journal of Surgical Oncology. https://doi.org/10.1002/jso.26090
Kim Y, et al. Predictors of Recurrence After Total Thyroidectomy Plus Neck Dissection and Radioactive Iodine Ablation for High-risk Papillary Thyroid Carcinoma. J Surg Oncol. 2020 Jun 25; PubMed PMID: 32588461.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of recurrence after total thyroidectomy plus neck dissection and radioactive iodine ablation for high-risk papillary thyroid carcinoma. AU - Kim,Yonghan, AU - Roh,Jong-Lyel, AU - Song,Dongeun, AU - Cho,Kyung-Ja, AU - Choi,Seung-Ho, AU - Nam,Soon Yuhl, AU - Kim,Sang Yoon, Y1 - 2020/06/25/ PY - 2020/01/17/received PY - 2020/05/11/revised PY - 2020/06/15/accepted PY - 2020/6/27/entrez KW - high risk KW - papillary thyroid carcinoma KW - predictive factors KW - recurrence KW - thyroidectomy JF - Journal of surgical oncology JO - J Surg Oncol N2 - BACKGROUND: American Thyroid Association (ATA) proposed management guidelines for differentiated thyroid cancer, including a three-tiered risk stratification system for structural recurrence. This study aimed to compare the various 2015 ATA criteria for the strength of association with the recurrence of high-risk papillary thyroid carcinoma (PTC). STUDY DESIGN: This study included 545 consecutive patients who underwent total thyroidectomy plus neck dissection and radioactive iodine ablation (RAI) for previously untreated high-risk PTC. The association of recurrence-free survival (RFS) with clinicopathological factors was evaluated by univariate and multivariate Cox proportional hazard regression analyses. RESULTS: During a follow-up median period of 89 months, 90 (16.5%) patients had any-site recurrence. Of the high-risk factors, high stimulated thyroglobulin (sTg) level and >3-cm sized lymph nodes (LNs) were significantly associated with recurrence (all P < .005). Sex, tumor size, lymphovascular invasion, multifocality, number of positive LNs, extranodal extension, T and N classifications, and overall tumor-node-metastasis stage were also significantly associated with recurrence (all P < .05). In multivariate analyses, high sTg level [adjusted hazard ratio (HR) = 7.18] and N1b (adjusted HR = 3.27) were independent factors predictive of recurrence (all P ≤ .001). CONCLUSIONS: Postoperative high serum sTg level might be the most important predictor of PTC recurrence after total thyroidectomy plus neck dissection and RAI. SN - 1096-9098 UR - https://www.unboundmedicine.com/medline/citation/32588461/Predictors_of_recurrence_after_total_thyroidectomy_plus_neck_dissection_and_radioactive_iodine_ablation_for_high-risk_papillary_thyroid_carcinoma L2 - https://doi.org/10.1002/jso.26090 DB - PRIME DP - Unbound Medicine ER -
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