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Prophylactic central lymph node dissection informs the decision of radioactive iodine ablation in papillary thyroid cancer

Nylén, Carolina (författare)
Karolinska Institutet
Bragvad Eriksson, Frida (författare)
Uppsala universitet,Endokrinkirurgi
Yang, Anna (författare)
Uppsala universitet,Endokrinkirurgi
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Aniss, Ahmad (författare)
Royal North Shore Hosp, Dept Endocrine Surg, Level 3, St Leonards, NSW 2065, Australia
Turchini, John (författare)
Univ Sydney, Fac Med & Hlth, Sydney Med Sch, Sydney, NSW 2006, Australia; Douglass Hanly Moir Pathol, Dept Histopathol, Macquarie Pk, NSW 2113, Australia; Macquarie Univ, MQ Hlth, Discipline Pathol, N Ryde, NSW 2109, Australia; Royal North Shore Hosp, Kolling Inst Med Res, Canc Diag & Pathol Grp, St Leonards, NSW 2065, Australia
Learoyd, Diana (författare)
Univ Sydney, Fac Med & Hlth, Sydney Med Sch, Sydney, NSW 2006, Australia; Royal North Shore Hosp, Dept Endocrinol & Diabet, St Leonards, NSW 2065, Australia
Robinson, Bruce G. (författare)
Univ Sydney, Fac Med & Hlth, Sydney Med Sch, Sydney, NSW 2006, Australia; Royal North Shore Hosp, Dept Endocrinol & Diabet, St Leonards, NSW 2065, Australia; Royal North Shore Hosp, Kolling Inst Med Res, Canc Genet Unit, St Leonards, NSW 2065, Australia
Gill, Anthony J. (författare)
Univ Sydney, Fac Med & Hlth, Sydney Med Sch, Sydney, NSW 2006, Australia; Royal North Shore Hosp, Kolling Inst Med Res, Canc Diag & Pathol Grp, St Leonards, NSW 2065, Australia; Royal North Shore Hosp, Dept Anat Pathol, NSW Hlth Pathol, St Leonards, NSW 2065, Australia
Clifton-Bligh, Roderick J. (författare)
Univ Sydney, Fac Med & Hlth, Sydney Med Sch, Sydney, NSW 2006, Australia; Royal North Shore Hosp, Dept Endocrinol & Diabet, St Leonards, NSW 2065, Australia; Royal North Shore Hosp, Kolling Inst Med Res, Canc Genet Unit, St Leonards, NSW 2065, Australia
Sywak, Mark S. (författare)
Royal North Shore Hosp, Dept Endocrine Surg, Level 3, St Leonards, NSW 2065, Australia; Univ Sydney, Fac Med & Hlth, Sydney Med Sch, Sydney, NSW 2006, Australia
Glover, Anthony R. (författare)
Royal North Shore Hosp, Dept Endocrine Surg, Level 3, St Leonards, NSW 2065, Australia; Univ Sydney, Fac Med & Hlth, Sydney Med Sch, Sydney, NSW 2006, Australia; Univ New South Wales Sydney, St Vincents Clin Sch, Fac Med,Garvan Inst Med Res, Endocrine Canc Program,Canc Theme, Kinghorn Canc C, Sydney, NSW 2010, Australia
Sidhu, Stan B. (författare)
Royal North Shore Hosp, Dept Endocrine Surg, Level 3, St Leonards, NSW 2065, Australia; Univ Sydney, Fac Med & Hlth, Sydney Med Sch, Sydney, NSW 2006, Australia; Royal North Shore Hosp, Kolling Inst Med Res, Canc Genet Unit, St Leonards, NSW 2065, Australia
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 (creator_code:org_t)
Elsevier BV, 2021
2021
Engelska.
Ingår i: American Journal of Surgery. - : Elsevier BV. - 0002-9610 .- 1879-1883. ; 221:5, s. 886-892
Relaterad länk:
https://urn.kb.se/re...
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https://doi.org/10.1...
http://kipublication...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • BackgroundProphylactic central lymph node dissection (CLND) in papillary thyroid cancer (PTC) is controversial. We aimed to investigate if prophylactic CLND aids risk stratification and contributes to the decision for postoperative RAI ablation.MethodsPatients undergoing thyroidectomy for PTC and prophylactic CLND were identified from an endocrine surgical unit database. Pathology reports where reviewed for number and size of lymph nodes and patients stratified by risk according to the ATA guidelines.Results426 patients were identified with PTC ≤4 cm and prophylactic CLND. 96 patients (23%) had central lymph node metastasis (CLNM) that qualified them for the intermediate risk group. In 17 patients (4%), the CLNM data led to upgrading independently of other histopathological characteristics. Correcting for multiple variables, CLNM was an independent factor contributing to RAI treatment.ConclusionProphylactic CLND provides information to aid the selection of RAI ablation independent of primary cancer histology for risk stratification in 4% of patients. This benefit should be carefully balanced with the risk of CLND and patient treatment choice when deciding on management of PTC ≤4 cm.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

Papillary thyroid cancer
Prophylactic central lymph node dissection
Radioactive iodine ablation
Risk assessment

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