1162P - Serum thyroglobulin levels after reoperation for nodal recurrence in patients who underwent total thyroidectomy for papillary thyroid carcinoma (PTC)

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Thyroid Cancer
Surgery and/or Radiotherapy of Cancer
Presenter DongHui Cho
Citation Annals of Oncology (2014) 25 (suppl_4): iv394-iv405. 10.1093/annonc/mdu345
Authors D. Cho, K.H. Choi
  • Surgery, Seoul Medical Center, 135-795 - Seoul/KR

Abstract

Aim

The recurrence of PTC is frequent in regional lymph node. Most of them need reoperation. The purpose of this study was to evaluate the serum thyroglobulin(Tg) levels before and after the second surgery in them and to analyze the postoperative result.

Methods

Patients who underwent reoperation for nodal recurrence after total thyroidectomy with or without central neck dissection for PTC by a single surgeon between January 2002 and June 2009 at Samsung Medical Center were enrolled. These are categorized into two groups based on the post-ablation Tg level measured after second operation; Group A(off-Tg<2ngml) and Group B(off-Tg>or = 2ng/ml).

Results

During follow-up period (mean 63.1 months), 32 patients(2.5%) had a recurrence in regional lymph node among total 1452 cases who underwent total thyroidectomy. Mean size of primary tumors was 2.0cm(0.4 ∼ 5.8). All of them had at least one metastatic node in central compartment during the first surgery. Most nodal recurrence was diagnosed by ultrasound and fine needle aspiration cytology but only 2 cases were dectected by computed tomography. 131 I whole body scan in 19 patients did not show any iodine uptake in the neck. Nodal recurrence was most common in ipsilateral lateral neck (18 cases); 13 cases in more than 2 compartments and 2 cases in supramediastinal node. Other 3 cases presented as a recurrence in central, contalateral and bilateral neck. The number of metastatic lymph nodes was 6(1 ∼ 18) on average at the second surgery. Before the second operation, postablation Tg level of 24 patients was 2ng/ml or more, but 12 patients of them had a postablation Tg level below 2ng/ml after second operatin. As compared between Group A and B, primary tumor size(p = 0.043), postablation Tg level after first operation(p = 0029) were significant prognostic factors for reduction of potablaton Tg levels after reoperation for nodal recurrence.

Conclusions

A nodal recurrence after total thyroidectomy for PTC was not common during early follow-up period and detected mainly by ultrasonography. Even for the patients presenting nodal recurrence, a proper nodal dissection could reduce the Tg level.

Disclosure

All authors have declared no conflicts of interest.