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Central compartment revision surgery for persistent or recurrent thyroid carcinoma: analysis of survival and complication rate

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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Locoregional recurrence of thyroid carcinoma is relatively common and reported rate are between 5 and 20%. Cervical nodes are usually involved, especially at the central compartment. The management of recurrent thyroid carcinoma at central compartment still remains challenging because of higher incidence of complication rate. The aim of the study is to evaluate the survival and complications rate after revision surgery.

Methods

Retrospective cohort study on a group of patients that underwent revision surgery for persistent or recurrent thyroid carcinoma from January 1, 2003 to December 31, 2017. Survival outcomes were calculated using Kaplan–Meier method. Significant variables on univariate analysis were subjected to a Cox proportional hazards regression multivariate model.

Results

Fifty-two patients involved, 22 male (40%) and 30 female (60%). Mean age was 54 years old (range 24–85). Mean follow-up was 79 months, median follow-up was 85 months, with a range between 8 and 153 months. The 5-year overall survival was 90.8% while at 10 years it was 69.8%. The 5-year disease-specific survival was 93.5%, while at 10 years it dropped to 77.9%. The rate of recurrent laryngeal nerve paralysis and persistent hypocalcemia in our series were 1.3% and 5.9%, respectively. No evidence of thoracic duct, esophageal or laryngeal and tracheal injury was found in this case series. Regarding prognostic factors, univariate and multivariate analysis highlighted as statistically significant: the aggressive histological variants, the presence extranodal extension or soft-tissue metastasis.

Conclusion

The surgical option remains the gold standard in locoregional recurrences of thyroid carcinoma and should be performed by experienced surgeons to reduce postoperative complications.

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References

  1. Kist JW, de Keizer B, Stokkel MPM, Hoekstra OS, Vogel WV, THYROPET Study Group (2014) Recurrent differentiated thyroid cancer: towards personalized treatment based on evaluation of tumor characteristics with PET (THYROPET Study): study protocol of a multicenter observational cohort study. BMC Cancer 14:405

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  2. Schvartz C, Bonnetain F, Dabakuyo S et al (2012) Impact on overall survival of radioactive iodine in low-risk differentiated thyroid cancer patients. J Clin Endocrinol Metab 97(5):1526–1535

    Article  PubMed  CAS  Google Scholar 

  3. Welsh L, Powell C, Pratt B et al (2013) Long-term outcomes following low-dose radioiodide ablation for differentiated thyroid cancer. J Clin Endocrinol Metab 98(5):1819–1825

    Article  PubMed  CAS  Google Scholar 

  4. Shaha AR (2012) Recurrent differentiated thyroid cancer. Endocr Pract 18(4):600–603

    Article  PubMed  Google Scholar 

  5. Schlumberger M, Challeton C, De Vathaire F et al (1996) Radioactive iodine treatment and external radiotherapy for lung and bone metastases from thyroid carcinoma. J Nucl Med 37(4):598–605

    PubMed  CAS  Google Scholar 

  6. Amit M, Tam S, Boonsripitayanon M et al (2018) Association of lymph node density with survival of patients with papillary thyroid cancer. JAMA Otolaryngol Head Neck Surg 144(2):108–114

    Article  PubMed  Google Scholar 

  7. Higgins TS, Gupta R, Ketcham AS, Sataloff RT, Wadsworth JT, Sinacori JT (2011) Recurrent laryngeal nerve monitoring versus identification alone on post-thyroidectomy true vocal fold palsy: a meta-analysis. Laryngoscope 121(5):1009–1017

    Article  PubMed  Google Scholar 

  8. Orloff LA, Wiseman SM, Bernet VJ et al (2018) American thyroid association statement on postoperative hypoparathyroidism: diagnosis, prevention, and management in adults. Thyroid 28(7):830–841

    Article  PubMed  Google Scholar 

  9. McMullen C, Rocke D, Freeman J (2017) Complications of bilateral neck dissection in thyroid cancer from a single high-volume center. JAMA Otolaryngol Head Neck Surg 143(4):376–381

    Article  PubMed  Google Scholar 

  10. Clayman GL, Agarwal G, Edeiken BS, Waguespack SG, Roberts DB, Sherman SI (2011) Long-term outcome of comprehensive central compartment dissection in patients with recurrent/persistent papillary thyroid carcinoma. Thyroid 21(12):1309–1316

    Article  PubMed  PubMed Central  Google Scholar 

  11. Magarey MJR, Freeman JL (2013) Recurrent well-differentiated thyroid carcinoma. Oral Oncol 49(7):689–694

    Article  PubMed  Google Scholar 

  12. Lang BH-H, Lee GCC, Ng CPC, Wong KP, Wan KY, Lo C-Y (2013) Evaluating the morbidity and efficacy of reoperative surgery in the central compartment for persistent/recurrent papillary thyroid carcinoma. World J Surg 37(12):2853–2859

    Article  PubMed  Google Scholar 

  13. Clayman GL, Shellenberger TD, Ginsberg LE et al (2009) Approach and safety of comprehensive central compartment dissection in patients with recurrent papillary thyroid carcinoma. Head Neck 31(9):1152–1163

    Article  PubMed  Google Scholar 

  14. Sherman SI, Angelos P, Ball DW et al (2005) Thyroid carcinoma. J Natl Compr Canc Netw 3(3):404–457

    Article  PubMed  Google Scholar 

  15. Schuff KG, Weber SM, Givi B, Samuels MH, Andersen PE, Cohen JI (2008) Efficacy of nodal dissection for treatment of persistent/recurrent papillary thyroid cancer. The Laryngoscope 118(5):768–775

    Article  PubMed  Google Scholar 

  16. National Comprehensive Cancer Network (2018) NCCN clinical practice guidelines (NCCN Guidelines®) in oncology: Thyroid cancer version 1.2018. https://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf. Accessed 20 Sept 2018

  17. Hughes DT, Laird AM, Miller BS, Gauger PG, Doherty GM (2012) Reoperative lymph node dissection for recurrent papillary thyroid cancer and effect on serum thyroglobulin. Ann Surg Oncol 19(9):2951–2957

    Article  PubMed  Google Scholar 

  18. Shah MD, Harris LD, Nassif RG, Kim D, Eski S, Freeman JL (2012) Efficacy and safety of central compartment neck dissection for recurrent thyroid carcinoma. Arch Otolaryngol Head Neck Surg 138(1):33–37

    Article  PubMed  Google Scholar 

  19. Cayonu M, Acar A, Eryilmaz A, Oguz O (2014) Surgical approach and outcomes for revision surgery of the central neck compartment. J Craniofac Surg 25(5):1797–1800

    Article  PubMed  Google Scholar 

  20. Barczyński M, Konturek A, Cichoń S (2009) Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy. Br J Surg 96(3):240–246

    Article  PubMed  Google Scholar 

  21. Randolph GW, Dralle H, International Intraoperative Monitoring Study Group et al (2011) Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: international standards guideline statement. Laryngoscope 121(Suppl 1):S1–S16

    Article  PubMed  Google Scholar 

  22. Kim MK, Mandel SH, Baloch Z et al (2004) Morbidity following central compartment reoperation for recurrent or persistent thyroid cancer. Arch Otolaryngol Head Neck Surg 130(10):1214–1216

    Article  PubMed  Google Scholar 

  23. Farrag TY, Agrawal N, Sheth S et al (2007) Algorithm for safe and effective reoperative thyroid bed surgery for recurrent/persistent papillary thyroid carcinoma. Head Neck 29(12):1069–1074

    Article  PubMed  Google Scholar 

  24. Alvarado R, Sywak MS, Delbridge L, Sidhu SB (2009) Central lymph node dissection as a secondary procedure for papillary thyroid cancer: is there added morbidity? Surgery 145(5):514–518

    Article  PubMed  Google Scholar 

  25. Ondik MP, Dezfoli S, Lipinski L, Ruggiero F, Goldenberg D (2009) Secondary central compartment surgery for thyroid cancer. Laryngoscope 119(10):1947–1950

    Article  PubMed  Google Scholar 

  26. Shen WT, Ogawa L, Ruan D et al (2010) Central neck lymph node dissection for papillary thyroid cancer: comparison of complication and recurrence rates in 295 initial dissections and reoperations. Arch Surg 145(3):272–275

    Article  PubMed  Google Scholar 

  27. Roh J-L, Kim J-M, Park CI (2011) Central compartment reoperation for recurrent/persistent differentiated thyroid cancer: patterns of recurrence, morbidity, and prediction of postoperative hypocalcemia. Ann Surg Oncol 18(5):1312–1318

    Article  PubMed  Google Scholar 

  28. Bergamini G, Alicandri-Ciufelli M, Molteni G (2010) Therapy of unilateral vocal fold paralysis with polydimethylsiloxane injection laryngoplasty: our experience. J Voice 24(1):119–125

    Article  PubMed  CAS  Google Scholar 

  29. Mattioli F, Bettini M, Botti C et al (2017) Polydimethylsiloxane injection laryngoplasty for unilateral vocal fold paralysis: long-term results. J Voice 31(4):517.e1–517.e7

    Article  Google Scholar 

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Funding

This study did not receive funding from any organization or institution.

Author information

Authors and Affiliations

  1. Otorhinolaryngology-Head and Neck Surgery Department, University Hospital of Verona, AOUI Borgo Trento, Piazzale Aristide Stefani, 1, 37126, Verona, Italy

    Gabriele Molteni

  2. Otorhinolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Largo del Pozzo, 71, 41125, Modena, Italy

    Marco Bonali, Francesco Mattioli, Michael Ghirelli, Matteo Fermi, Gaetano Ferri & Livio Presutti

  3. Department of Medical and Surgical Sciences for Children & Adults, Infectious Disease Clinic, University of Modena and Reggio Emilia, Modena, Italy

    Malagoli Andrea

Authors
  1. Gabriele Molteni
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  2. Marco Bonali
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  3. Francesco Mattioli
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  4. Michael Ghirelli
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  5. Matteo Fermi
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  6. Gaetano Ferri
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  7. Malagoli Andrea
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  8. Livio Presutti
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Corresponding author

Correspondence to Michael Ghirelli.

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Conflict of interest

The authors declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Cite this article

Molteni, G., Bonali, M., Mattioli, F. et al. Central compartment revision surgery for persistent or recurrent thyroid carcinoma: analysis of survival and complication rate. Eur Arch Otorhinolaryngol 276, 551–557 (2019). https://doi.org/10.1007/s00405-018-5239-2

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  • DOI: https://doi.org/10.1007/s00405-018-5239-2

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