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Annals of Surgical Oncology

, Volume 21, Issue 4, pp 1379–1383 | Cite as

Radioactive Iodine Remnant Uptake After Completion Thyroidectomy: Not Such a Complete Cancer Operation

  • Sarah C. Oltmann
  • David F. Schneider
  • Glen Leverson
  • Tamilselvan Sivashanmugam
  • Herbert Chen
  • Rebecca S. Sippel
Endocrine Tumors

Abstract

Background

Given limitations in preoperative diagnostics, thyroid lobectomy followed by completion thyroidectomy (CT) for differentiated thyroid cancer (DTC) may be required. It is unclear whether resection quality by CT differs from that by total thyroidectomy (TT). Additional surgeon or patient factors may also influence the “completeness” of resection. This study evaluated how CT and surgeon volume influence the adequacy of resection as measured by radioactive iodine (RAI) remnant uptake.

Methods

A retrospective review of a prospectively collected thyroid database was queried for patients treated for DTC with TT or CT followed by RAI ablation. CT patients were matched 1:2 by age, sex, and tumor size to TT patients. Surgeon volume, time to completion, and continuity of surgeon care were reviewed.

Results

Over 18 years, 45 patients with DTC had CT and RAI. Mean age was 48 ± 2 years, and 76 % were female, with a tumor size of 2.7 ± 0.3 cm. CT had higher remnant uptake than TT (0.07 vs. 0.04 %; p = 0.04). CT performed by a high-volume surgeon had much lower remnant uptakes (0.06 vs. 0.22 %; p = 0.04). Remnant uptake followed a stepwise decrease with involvement of a high-volume surgeon for part or all of the surgical management (p = 0.11). Multiple regression analysis found CT (p = 0.02) and surgeon volume (p = 0.04) to significantly influence uptake after controlling for other factors.

Conclusions

Single-stage TT provides a better resection based on smaller thyroid remnant uptakes than CT for patients with thyroid cancer. If a staged operation for cancer is necessary, surgeon volume may affect the completeness of resection.

Keywords

Thyroid Cancer Total Thyroidectomy Differentiate Thyroid Cancer Completion Thyroidectomy Thyroid Cancer Recurrence 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

This study was supported by NIH T32 CA009614-23.

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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Sarah C. Oltmann
    • 1
  • David F. Schneider
    • 1
  • Glen Leverson
    • 2
  • Tamilselvan Sivashanmugam
    • 3
  • Herbert Chen
    • 1
  • Rebecca S. Sippel
    • 1
  1. 1.Section of Endocrine Surgery, Department of SurgeryUniversity of Wisconsin, MadisonMadisonUSA
  2. 2.Department of SurgeryUniversity of Wisconsin, MadisonMadisonUSA
  3. 3.Wellcare Hospital and Research InstituteTrichyIndia

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