Management and outcome of clinically evident neck recurrence in patients with papillary thyroid cancer Journal Article

Authors: Wang, L. Y.; Migliacci, J. C.; Tuttle, R. M.; Shaha, A. R.; Shah, J. P.; Patel, S. G.; Ganly, I.
Article Title: Management and outcome of clinically evident neck recurrence in patients with papillary thyroid cancer
Abstract: Background: The aim of this study was to report our incidence of clinically evident neck recurrence, salvage neck management and subsequent outcomes in patients with papillary thyroid cancer. This is important to know so that patients with thyroid cancer can be properly counselled about the implications of recurrent disease and subsequent outcome. Methods: An institutional database of 3664 patients with thyroid cancer operated between 1986 and 2010 was reviewed. Patients with nonpapillary histology and gross residual disease and those with distant metastases at presentation or distant metastases prior to nodal recurrence were excluded from the study. Of these, 99 (3.0%) patients developed clinically evident nodal recurrence. Details of recurrence and subsequent therapy were recorded for each patient. Subsequent disease-specific survival (sDSS), distant recurrence-free survival (sDRFS) and nodal recurrence-free survival (sNRFS) were determined from the date of first nodal recurrence using the Kaplan-Meier method. Results: Of the 99 patients, 59% were female and 41% male. The median age was 41 years (range 5-91). The majority of patients had pT3/4 primary tumours (63%) and were pN+ (78%) at initial presentation. The median time to clinically evident nodal recurrence was 28 months (range: 3-264). Nodal recurrence occurred in the central neck in 15 (15%) patients, lateral neck in 74 (75%) patients and both in 10 (10%) patients. After salvage treatment, the 5-year sDSS was 97.4% from time of nodal recurrence. The 5-year sDRFS and sNRFS were 89.2% and 93.7%, respectively. Conclusion: In our series, isolated clinically evident nodal recurrence occurred in 3.0% of patients. Such patients are successfully salvaged with surgery and adjuvant therapy with sDSS of 97.4% at 5 years. © 2017 John Wiley & Sons Ltd
Keywords: survival; adolescent; adult; cancer survival; child; aged; cancer surgery; primary tumor; major clinical study; cancer recurrence; bone metastasis; cancer adjuvant therapy; cancer patient; lymph nodes; histology; distant metastasis; lung metastasis; minimal residual disease; brain metastasis; external beam radiotherapy; outcomes; thyroid papillary carcinoma; disease specific survival; recurrence free survival; clinical outcome; papillary thyroid cancer; human; male; female; priority journal; article; neck recurrence
Journal Title: Clinical Endocrinology
Volume: 87
Issue: 5
ISSN: 0300-0664
Publisher: Wiley Blackwell  
Date Published: 2017-11-01
Start Page: 566
End Page: 571
Language: English
DOI: 10.1111/cen.13378
PROVIDER: scopus
PMCID: PMC5658234
PUBMED: 28516448
Notes: Article -- Export Date: 4 December 2017 -- Source: Scopus
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MSK Authors
  1. Ashok R Shaha
    535 Shaha
  2. Snehal G Patel
    286 Patel
  3. Robert M Tuttle
    350 Tuttle
  4. Ian Ganly
    229 Ganly
  5. Jatin P Shah
    538 Shah
  6. Laura Wang
    34 Wang