Locoregional Recurrence in Papillary Thyroid Carcinoma

Han, Koon Taek

Abstract

PURPOSE: The author performed this study to find factors influencing the locoregional recurrence in papillary thyroid carcinoma (PTC) with reference to the adequacy of initial treatment.
MATERIALS AND METHODS
Records of 13 patients who had received a surgical therapy for locoregional recurrence of PTC at Pusan National University Hospital between January 1993 and December 1996 were analyzed retrospectively.
RESULTS
Twelve patients received the surgery after initial recurrence, while one patient after the 2nd recurrence. At the time of initial surgical therapy, mean age of patients was 51.4 years; 10 patients (76.9%) were female; PTC was documented preor intraoperatively in 3 patients (23.1%); 1 patient (7.7%) had a combined preoperative ultrasonography and computed tomography (CT) of the neck; mode of operation was lobectomy in 9 patients (69.2%), total thyroidectomy in 2 patients (15.4%) and total thyroidectomy with neck dissection in 2 patients (15.4%). At the time of second surgical therapy, pattem of recurrence was regional in 7 patients (53.8%), combined locoregional in 4 patients 30.8%) and local in 2 patient (15.4%); mode of operation was complete thyroidectomy with neck dissection in 9 patients (69.2%), neck dissection in 2 patients (15.4%), and local excision in 2 patients (15.4%). Final outcome of patients (mean follow-up period, 2.8 years) was successful in 6 patients (46.2.%).
CONCLUSION
The data suggest that many cases of locoregional recurrence in PTC occur as a consequence of poor initial therapy. A combined thyroid ultrasonography and neck CT is recommended as a routine preoperative check during initial therapy. The author believes that a total thyroidectomy is the surgical procedure of choice, which facilitates postoperative I therapy.