Uruno Takashi, Miyauchi Akira, Shimizu Kazuo, Nakano Keiichi, Takamura Yuuki, Ito Yasuhiro, Miya Akihiro, Kobayashi Kaoru, Yokozawa Tamotsu, Matsuzuka Fumio, Kuma Kanji
Department of Surgery, Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan.
Surg Today. 2004;34(11):891-5. doi: 10.1007/s00595-004-2852-z.
To investigate the factors associated with a favorable prognosis after reoperation for local recurrent papillary thyroid carcinoma (PTC), we reviewed 45 patients who underwent surgery for first local recurrence of PTC.
We divided the patients into two groups. Group A (n = 28) had no second recurrence, and group B (n = 17) had second local recurrence after surgery for recurrence.
The mean follow-up period after reoperation was 56.9 months. The mean age at the time of reoperation in group A was significantly lower than that in group B, at 48.1 years versus 62.3 years, respectively (P = 0.0007). The mean age at the time of the initial operation in group A was also significantly lower than that in group B, at 40.1 years versus 55.1 years, respectively (P = 0.0006). Patients with recurrent tumors only outside the area dissected at the initial operation (n = 27) had a better outcome than those with recurrence within the dissected area (n = 18; P = 0.0127). Patients who underwent systematic partial or modified neck dissection (n = 36) had a better outcome than those who underwent only simple local resection (n = 9; P = 0.0169).
For local recurrent PTC, systematic neck dissection is recommended over local resection of recurrent tumors.
