The Clinicopathological Features and Postoperative Complications of Completion Thyroidectomy for Recurrent Papillary Thyroid Carcinoma

Kim, Chang Woo; Lee, So Hee; Ryu, Haeng Rang; Rhee, Kang Young; Kang, Sang Wook; Jung, Jong Joo; Nam, Kee Hyun; Chang, Hang Seok; Chung, Woong Youn; Park, Cheong Soo

Abstract

PURPOSE
A completion thyroidectomy after less than total thyroidectomy is needed for the treatment of recurrent papillary thyroid carcinoma (PTC). The aim of this study is to evaluate the clinicopathological features and the postoperative complications of completion thyroidectomy for patients with recurrent PTC.
METHODS
A total 94 PTC patients who had undergone prior less than total thyroidectomy underwent completion thyroidectomy for recurrence from March 1986 to June 2009. We retrospectively analyzed the clinicopathological features and postoperative complications.
RESULTS
At the initial operation, the patients' mean age was 38.2 years old. Central node metastasis was found in 37 cases and extrathyroidal invasion was found in 12 cases. The mean interval time between the initial operation to the completion thyroidectomy was 76.6 months. Fifty six patients underwent completion thyroidectomy only and 38 underwent a completion thyroidectomy combined with a modified radical neck dissection. In the combined group, central neck node metastasis and extrathyroidal invasion at the time of the initial operation were significantly more frequent than those in the completion thyroidectomy only group. The postoperative complications were 14 cases of transient hypocalcemia and 8 cases of permanent hypocalcemia and there were no significant differences between the two groups.
CONCLUSION
When performing completion thyroidectomy, it is important to check the lateral neck nodes for metastasis when central neck node metastasis or extrathyroidal invasion were present at the initial operation, and this can be done safely without severe complications even though it is combined with modified radical neck dissection.