Impact of extent thyroidectomy and radioactive iodine ablation for disease free survival in the intermediate-risk patients with lateral neck lymph node metastasis: a retrospective and tentative real-world approach.
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引用次数: 0
Abstract
Background: It is controversial whether or not total thyroidectomy followed by radioactive iodine ablation (RAI-a) (30 mCi = 1.1 GBq) is mandatory in intermediate-risk patients with lateral neck lymph node metastasis (cN1b).
Methods: This retrospective observational study enrolled PTC patients classified preoperatively as the intermediate-risk with cN1b from January 2010 to December 2017 according to the guidelines for thyroid tumors of the Japanese Association of Endocrine Surgeons (JAES) since 2009. We analyzed recurrence-free survival (RFS) rates estimated by the Kaplan-Meier method in the patients classified into three groups: 1) total thyroidectomy (TTx) followed by lateral neck lymph node dissection (LLND) with RAI-a, 2) TTx + LLND without RAI-a, 3) hemithyroidectomy + LLND. In addition, propensity score analysis adjusted by clinical parameters was performed.
Results: Two hundred eighty-eight patients with intermediate-risk PTC were identified. Among them, 87 patients with cN1b were analyzed. Five-year RFS rates in 1), 2), and 3) groups were 85.0%, 100%, and 90.9%, respectively. The analysis of 1) and 2) groups by propensity score matching revealed 5-yr RFS rates of 84.1% and 100%, respectively (p < 0.0432).
Conclusions: There was no evidence to support the use of 30 mCi (1.1GBq) radioactive iodine postoperatively to prevent recurrence in intermediate-risk PTC patients with cN1b.
期刊介绍:
World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics.
Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.