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Article: Predictive Factors and Pattern of Locoregional Recurrence After Prophylactic Central Neck Dissection in Papillary Thyroid Carcinoma

TitlePredictive Factors and Pattern of Locoregional Recurrence After Prophylactic Central Neck Dissection in Papillary Thyroid Carcinoma
Authors
Issue Date2014
PublisherSpringer New York LLC. The Journal's web site is located at http://www.annalssurgicaloncology.org
Citation
Annals of Surgical Oncology, 2014, v. 21 n. 13, p. 4181-4187 How to Cite?
Abstract© 2014, Society of Surgical Oncology. Background: Prophylactic central neck dissection (pCND) at the time of the total thyroidectomy (TT) remains controversial in clinically nodal-negative (cN0) papillary thyroid carcinoma. Our study was designed to examine the predictive factors and pattern of locoregional recurrence (LRR) after pCND in the context of the postoperative stimulated Tg (sTg) level. Results: After a follow-up of 66.6 ± 38.6 months, 14 (4.1 %) suffered from LRR. The duration to first LRR was 36.4 ± 21.7 months. The estimated 5- and 10-year LRR rates were 5.1 and 6.1 %, respectively. Of these 14 LRR, 3 (21.4 %) involved the central compartment alone, 9 (64.3 %) involved the lateral compartment alone, and 2 (14.3 %) involved both central and lateral compartments. After adjusting for other clinicopathological factors, postablation sTg level ≥ 1 µg/L (hazard ratio 265.109, 95 % confidence interval 1.132–62075.644, p = 0.045) was the only independent predictor of LRR. Conclusions: Annualized risk of LRR after pCND was approximately 1 % in the first 5 years and 0.2 % in the subsequent 5 years. Most (78.6 %) LRRs involved the lateral compartment. Postablation sTg ≥ 1 µg/L significantly predicted risk of LRR. Methods: A total of 341 patients who underwent TT and unilateral pCND were analyzed. Patients with an identifiable lesion on ultrasonography or whole-body scan within 6 months of surgery were excluded. LRR was defined as an identifiable lesion on USG, which was later confirmed by cytology/histology. Preablation sTg level was taken 2 months after surgery, whereas postablation sTg level was taken 8 months after surgery. Cox regression was used in the univariate and multivariate analyses to identify significant independent factors for LRR.
Persistent Identifierhttp://hdl.handle.net/10722/199135
ISSN
2015 Impact Factor: 3.655
2015 SCImago Journal Rankings: 1.902

 

DC FieldValueLanguage
dc.contributor.authorLang, HHBen_US
dc.contributor.authorChan, DTen_US
dc.contributor.authorWong, KPen_US
dc.contributor.authorWong, CKHen_US
dc.contributor.authorWan, KYen_US
dc.date.accessioned2014-07-22T01:04:32Z-
dc.date.available2014-07-22T01:04:32Z-
dc.date.issued2014en_US
dc.identifier.citationAnnals of Surgical Oncology, 2014, v. 21 n. 13, p. 4181-4187en_US
dc.identifier.issn1068-9265-
dc.identifier.urihttp://hdl.handle.net/10722/199135-
dc.description.abstract© 2014, Society of Surgical Oncology. Background: Prophylactic central neck dissection (pCND) at the time of the total thyroidectomy (TT) remains controversial in clinically nodal-negative (cN0) papillary thyroid carcinoma. Our study was designed to examine the predictive factors and pattern of locoregional recurrence (LRR) after pCND in the context of the postoperative stimulated Tg (sTg) level. Results: After a follow-up of 66.6 ± 38.6 months, 14 (4.1 %) suffered from LRR. The duration to first LRR was 36.4 ± 21.7 months. The estimated 5- and 10-year LRR rates were 5.1 and 6.1 %, respectively. Of these 14 LRR, 3 (21.4 %) involved the central compartment alone, 9 (64.3 %) involved the lateral compartment alone, and 2 (14.3 %) involved both central and lateral compartments. After adjusting for other clinicopathological factors, postablation sTg level ≥ 1 µg/L (hazard ratio 265.109, 95 % confidence interval 1.132–62075.644, p = 0.045) was the only independent predictor of LRR. Conclusions: Annualized risk of LRR after pCND was approximately 1 % in the first 5 years and 0.2 % in the subsequent 5 years. Most (78.6 %) LRRs involved the lateral compartment. Postablation sTg ≥ 1 µg/L significantly predicted risk of LRR. Methods: A total of 341 patients who underwent TT and unilateral pCND were analyzed. Patients with an identifiable lesion on ultrasonography or whole-body scan within 6 months of surgery were excluded. LRR was defined as an identifiable lesion on USG, which was later confirmed by cytology/histology. Preablation sTg level was taken 2 months after surgery, whereas postablation sTg level was taken 8 months after surgery. Cox regression was used in the univariate and multivariate analyses to identify significant independent factors for LRR.-
dc.languageengen_US
dc.publisherSpringer New York LLC. The Journal's web site is located at http://www.annalssurgicaloncology.org-
dc.relation.ispartofAnnals of Surgical Oncologyen_US
dc.rightsThe original publication is available at www.springerlink.com-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titlePredictive Factors and Pattern of Locoregional Recurrence After Prophylactic Central Neck Dissection in Papillary Thyroid Carcinomaen_US
dc.typeArticleen_US
dc.identifier.emailLang, HHB: Blang@hku.hken_US
dc.identifier.authorityLang, HHB=rp01828en_US
dc.description.naturepostprint-
dc.identifier.doi10.1245/s10434-014-3872-6-
dc.identifier.scopuseid_2-s2.0-84911960499-
dc.identifier.hkuros230865en_US
dc.identifier.volume21-
dc.identifier.issue13-
dc.identifier.spage4181-
dc.identifier.epage4187-
dc.publisher.placeUnited States-

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