EP130 – How does neck dissection affect local recurrence in PTC?

     

    Semenov, Arseny1,2; Chernikov, Roman1; Borozdina , Sofia2; Makarin, Viktor1;  Sleptsov, Ilya1; Chinchuk , Igor1; Novokshonov, Konstantin1; Karelina, Julia1; Uspenskaya, Anna1; Timofeeva, Nataly1; Vorobev, Sergey3; Kulyash, Alexey3; Fedorov, Elisey1; Malyugov, Yuriy1; Bubnov, Aleksandr1,2,4; Valdina, Elena5.
    1 Northwest center of endocrinology and endocrine surgery, University clinic, SPbSU, Saint-Petersburg, Russia
    2 Faculty of Medicine, SPbSU, Saint-Petersburg, Russia
    3 Department of morphology, University clinic, SPbSU, Saint-Petersburg, Russia
    4 Department of operative surgery and clinical anatomy, North-Western State Medical University named after I.I.Mechnikov  Saint-Petersburg, Russia
    5 University Hospital of Saint-Petersburg State University, Saint-Petersburg, Russia

     

    Retrospective cohort study of patients receiving primary treatment at the North-West centre for endocrinology and endocrine surgery in the period 2006-2011, for PTC. The study included only patients who underwent primary surgery in the volume of thyroidectomy with or without neck dissection. The decision on dissection was made after preoperative ultrasound or intraoperative findings. Prophylactic CND was not performed. Therapy with RAI was performed in accordance with the ETA guidelines.

    Patients included were routinely controlled with ultrasound and serum thyroglobulin.

    Among the 1428 patients operated on for papillary thyroid carcinoma, 1122 underwent thyroidectomy, 306 patients were operated on in the extent of thyroidectomy with central or central and lateral lymph node dissection. Regional recurrence was detected in 17 cases (1.7%) after total thyroidectomy without dissection in 10 cases (3.3%) after total thyroidectomy with lymph node dissection. The difference was found statistically significant (p=0.02), so selective neck dissection in patients with papillary thyroid cancer does not decrease the probability of regional recurrence.

    Age of patients after thyroidectomy without recurrence was 49.03±13.72 years and patients with recurrence of the same group of 47.59±19.2 years, relapse occurred an average after 3.74±6.07 years. Age of patients underwent neck dissection without relapse was 45.3±14.42, while age of patients with recurrence was 45.3±14.42. Relapse occurred after 1.71±2.63 years. The differences between time before recurrence was statistically significant (p=0.02), probably due to more aggressive tumor origin. Dependencies between gender, age of the patients and the frequency of relapse have been detected in both groups (p = 0.12; p = 0.43).

 

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