Ryoo Inseon, Kim Dong Wook, Lee Chang Yoon, Huh Jung Yin, Lee Song, Ahn Hye Shin, Sung Jin Yong
1 Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
2 Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Acta Radiol. 2018 Feb;59(2):196-203. doi: 10.1177/0284185117700448. Epub 2017 Mar 26.
Background In papillary thyroid carcinoma (PTC) patients, postoperative ultrasonography (US) surveillance is recommended at intervals of six or 12 months even though evidence is weak. Purpose To determine the optimal interval of postoperative US surveillance in patients after total thyroidectomy for the treatment of PTC using multicenter data. Material and Methods A total of 1400 patients from seven tertiary hospitals who underwent total thyroidectomy for treatment of PTC were included. Based on a retrospective review of clinical and pathologic results, multiple factors were analyzed according to recurrence/persistence or no recurrence/persistence. In recurrence/persistence group, the interval and number of follow-up US sessions in the initial detection of recurrence/persistence were investigated. Results Of the 1400 patients, 115 (8.2%) showed tumor recurrence/persistence on follow-up US. Of 115 recurrence/persistence cases, 89 (77.4%) were initially detected on US: nodal recurrence/persistence (n = 92), non-nodal recurrence/persistence (n = 22), and both (n = 1). Among the clinical and pathologic factors, only tumor size and N stage were significant predictors for recurrence/persistence. In the recurrence/persistence group, the mean interval and number of follow-up US sessions in the initial detection of recurrence/persistence was 22.3 ± 16.8 months and 2.2 ± 1.9, respectively. Approximately two-thirds of recurrence/persistence cases (76/115, 66.1%) were detected in follow-up US within two years after total thyroidectomy. Conclusion In PTC patients after total thyroidectomy, the optimal interval of the first US follow-up may be one to two years after thyroid surgery, and the appropriate number of postoperative US surveillance sessions within the first five years may be only one or two.
在甲状腺乳头状癌（PTC）患者中，尽管证据不足，但仍建议术后每隔6或12个月进行超声（US）监测。目的：利用多中心数据确定接受全甲状腺切除术治疗PTC的患者术后US监测的最佳间隔时间。材料与方法：纳入来自7家三级医院的1400例接受全甲状腺切除术治疗PTC的患者。基于对临床和病理结果的回顾性分析，根据复发/持续存在或无复发/持续存在情况分析多种因素。在复发/持续存在组中，调查复发/持续存在初次检测时的随访US间隔时间和次数。结果：1400例患者中，115例（8.2%）在随访US时出现肿瘤复发/持续存在。在115例复发/持续存在病例中，89例（77.4%）初次通过US检测到：淋巴结复发/持续存在（n = 92）、非淋巴结复发/持续存在（n = 22）以及两者皆有（n = 1）。在临床和病理因素中，只有肿瘤大小和N分期是复发/持续存在的显著预测因素。在复发/持续存在组中，复发/持续存在初次检测时的随访US平均间隔时间和次数分别为22.3±16.8个月和2.2±1.9次。约三分之二的复发/持续存在病例（76/115，66.1%）在全甲状腺切除术后两年内的随访US中被检测到。结论：在接受全甲状腺切除术的PTC患者中，首次US随访的最佳间隔时间可能是甲状腺手术后1至2年，并且在术后前5年内适当的US监测次数可能仅为1或2次。
