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Hormones

, Volume 15, Issue 4, pp 511–517 | Cite as

Low-risk papillary thyroid carcinoma patients who underwent near-total thyroidectomy without prophylactic central compartment lymph node dissection and were ablated with low-dose 50mCi RAI had excellent 10-year prognosis

  • Marina Michalaki
  • Panagiotis Bountouris
  • Nikolaos D. Roupas
  • Anastasia Theodoropoulou
  • Niki Agalianou
  • Theodoras Alexandrides
  • Kostas Markou
Research paper
  • 2 Downloads

Abstract

BACKGROUND

The current trend in the management of low risk differentiated thyroid carcinoma is to follow less aggressive strategies.

OBJECTIVE

To assess the long-term morbidity and mortality outcomes of low-risk papillary thyroid carcinoma (PTC) patients undergoing minimal intervention.

DESIGN

We retrospectively analyzed 137 patients with low-risk PTC (stage I: n=77; stage II: n=60). Of these patients, 107 (Group 1) had macro-PTC and underwent near-total thyroidectomy and received postoperatively 50mCi RAI. The remaining 30 patients (Group 2) had micro-PTC (<1cm) and were treated only by means of near-total thyroidectomy.

RESULTS

The median follow-up for Group 1 patients was 10 years (range: 3–30). At 1-year evaluation, 8 patients of Group 1 had indeterminate or incomplete biochemical response, of whom 4 had also incomplete structural response to initial therapy. Only 1 of 4 patients with structural incomplete response underwent cervical lymph node dissection and then received an additional dose of 100mCi RAI. The remaining 7 patients received only an additional dose of 100mCi RAI. These patients have been continuously followed till the present time with no recurrences or deaths (median follow-up: 17.5 years; 3–30 years). At 15 years, 2 patients of Group 1 experienced biochemical recurrence and they received 100mCi RAI. Three patients of Group 2 experienced recurrence, with 2 receiving 50mCi RAI and 1 undergoing cervical lymph node dissection with 50mCi RAI.

CONCLUSIONS

Patients with low-risk macro-PTC treated by means of near-total thyroidectomy without PCCLND and receiving postoperatively a low dose of 50mCi RAI have excellent long-term prognosis.

Key words

Low risk Prognosis Papillary thyroid carcinoma RAI Recurrence Prognosis 

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Copyright information

© Hellenic Endocrine Society 2016

Authors and Affiliations

  • Marina Michalaki
    • 1
    • 2
  • Panagiotis Bountouris
    • 1
  • Nikolaos D. Roupas
    • 1
  • Anastasia Theodoropoulou
    • 1
  • Niki Agalianou
    • 1
  • Theodoras Alexandrides
    • 1
  • Kostas Markou
    • 1
  1. 1.Endocrine Division, Internal Medicine DepartmentUniversity of Patras, Medical SchoolRion, PatrasGreece
  2. 2.University Hospital of PatrasRion, PatrasGreece

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