Suspicious cervical lymph nodes detected after thyroidectomy for papillary thyroid cancer usually remain stable over years in properly selected patients Journal Article

  

Authors:	Robenshtok, E.; Fish, S.; Bach, A.; Domínguez, J. M.; Shaha, A.; Tuttle, R. M.
Article Title:	Suspicious cervical lymph nodes detected after thyroidectomy for papillary thyroid cancer usually remain stable over years in properly selected patients
Abstract:	Context: The risk of loco-regional recurrence in papillary thyroid cancer (PTC) patients ranges from 15-30%. However, the clinical significance of small-volume loco-regional recurrence detected by highly sensitive ultrasonography is unclear. Objective: Our objective was to describe the natural history of abnormal cervical lymph nodes (LN) diagnosed after initial treatment. Design: We conducted a retrospective cohort study. Patients: 166 PTC with patients who had at least one abnormal LN outside the thyroid be on ultrasound and selected for active surveillance were included. Main Outcome Measure: LN growth during a period of active surveillance was the primary outcome. Results: Most patients had classical PTC (85%) and an intermediate risk of recurrence (77%). The median LN size at the start of the observation period was 1.3 cm (range, 0.5-2.7 cm) in largest diameter, with all nodes having at least one abnormal sonographic characteristic (70% of patients had LN with at least two abnormal features). In almost all patients, the LN were in the lateral neck, primarily in levels 3 (43%) and 4 (58%). After a median follow-up of 3.5 yr, only 20% (33 of 166) grew at least 3 mm, 9% (15 of 166) grew at least 5 mm, and 14% (23 of 166) resolved. None of the clinical or sonographic features were predictive of LN growth (positive predictive value range =0.21-0.57). There were no local complications (nerve damage or local invasion) related to the abnormal nodes and no disease-related mortality. Conclusions: Suspicious cervical LN in the lateral neck usually remain stable for long periods of time in properly selected PTC patients and can be safely followed with serial ultrasounds. Copyright © 2012 by The Endocrine Society.
Journal Title:	Journal of Clinical Endocrinology and Metabolism
Volume:	97
Issue:	8
ISSN:	0021-972X
Publisher:	Oxford University Press
Date Published:	2012-08-01
Start Page:	2706
End Page:	2713
Language:	English
DOI:	10.1210/jc.2012-1553
PROVIDER:	scopus
PUBMED:	22639292
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84864797345&partnerID=40&md5=7c7daf27d10b159c70027ec80c36f097
Notes:	--- - "Cited By (since 1996): 1" - "Export Date: 4 September 2012" - "CODEN: JCEMA" - "Source: Scopus"

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