Annals of Surgical Oncology

, Volume 21, Issue 6, pp 1884–1890 | Cite as

Risk Factors for Recurrence After Therapeutic Lateral Neck Dissection for Primary Papillary Thyroid Cancer

  • Su-jin Kim
  • Seog Yun Park
  • You Jin Lee
  • Eun Kyung Lee
  • Seok-ki Kim
  • Tae Hyun Kim
  • Yu-Seog Jung
  • Junsun Ryu
  • Jun Pyo Myong
  • Ki-Wook Chung
Endocrine Tumors

Abstract

Background

Lateral lymph node metastasis is an important prognostic factor and is predictive of tumor recurrence and cause-specific survival in patients with papillary thyroid cancer (PTC). However, the factors predicting recurrence and clinical outcomes after therapeutic lateral neck dissection are not well established. The aims of this study were to evaluate the incidence, pattern, and factors predictive of PTC recurrence after therapeutic lateral neck dissection.

Materials and Methods

The records of 126 consecutive patients who underwent total thyroidectomy with therapeutic lateral neck dissection for primary PTC at the National Cancer Center were retrospectively reviewed. The factors predictive of recurrence were determined using both univariate and multivariate analyses considering several clinicopathologic variables.

Results

The median follow-up period was 61.2 months, during which 22 patients (17.5 %) experienced recurrence with 1 death (0.8 %) due to disease. Locoregional recurrence and distant metastasis were found in 20 cases (15.9 %) and 2 cases (1.6 %), respectively. Male gender, aggressive histology, number of lymph node metastases, initial level of T4-off Tg per ng/mL, and ATA risk categories (high risk) were independent risk factors for recurrence. Of note, initial T4-off Tg levels greater than 4.2 ng/mL showed highest sensitivity and specificity in predicting recurrence.

Conclusions

These results provide useful information regarding the clinical outcomes after therapeutic lateral neck dissection for primary PTC and can be used to identify at-risk patients who need aggressive treatment and intensive surveillance for postoperative recurrence.

Supplementary material

10434_2014_3507_MOESM1_ESM.tiff (207 kb)
ROC analysis to determine an optimal off Tg level recurrence after therapeutic lateral neck dissection that maximized sensitivity and specificity, i.e., the point on the ROC curve farthest from chance. (TIFF 207 kb)

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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Su-jin Kim
    • 1
    • 2
    • 3
  • Seog Yun Park
    • 4
  • You Jin Lee
    • 4
  • Eun Kyung Lee
    • 4
  • Seok-ki Kim
    • 4
  • Tae Hyun Kim
    • 4
  • Yu-Seog Jung
    • 4
  • Junsun Ryu
    • 4
  • Jun Pyo Myong
    • 5
  • Ki-Wook Chung
    • 4
    • 6
  1. 1.Department of SurgerySeoul National University Hospital & College of MedicineSeoulKorea
  2. 2.Cancer Research InstituteSeoul National University College of MedicineSeoulKorea
  3. 3.Division of Surgery, Thyroid CenterSeoul National University Cancer HospitalSeoulKorea
  4. 4.Center for Thyroid CancerNational Cancer CenterGoyangKorea
  5. 5.Department of Occupational and Environmental Medicine, Seoul St. Mary’s HospitalThe Catholic UniversitySeoulKorea
  6. 6.Department of SurgeryAsan Medical CenterSeoulKorea

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