Low-risk papillary thyroid carcinoma patients who underwent near-total thyroidectomy without prophylactic central compartment lymph node dissection and were ablated with low-dose 50mCi RAI had excellent 10-year prognosis.
Hormones (Athens)
; 15(4): 511-517, 2016 Oct.
Article
em En
| MEDLINE
| ID: mdl-28222412
ABSTRACT
BACKGROUND:
The current trend in the management of low risk differentiated thyroid carcinoma is to follow less aggressive strategies.OBJECTIVE:
To assess the long-term morbidity and mortality outcomes of low-risk papillary thyroid carcinoma (PTC) patients undergoing minimal intervention.DESIGN:
We retrospectively analyzed 137 patients with low-risk PTC (stage I n=77; stage II n=60). Of these patients, 107 (Group 1) had macro-PTC and underwent near-total thyroidectomy and received postoperatively 50mCi RAI. The remaining 30 patients (Group 2) had micro-PTC (<1cm) and were treated only by means of near-total thyroidectomy.RESULTS:
The median follow-up for Group 1 patients was 10 years (range 3-30). At 1-year evaluation, 8 patients of Group 1 had indeterminate or incomplete biochemical response, of whom 4 had also incomplete structural response to initial therapy. Only 1 of 4 patients with structural incomplete response underwent cervical lymph node dissection and then received an additional dose of 100mCi RAI. The remaining 7 patients received only an additional dose of 100mCi RAI. These patients have been continuously followed till the present time with no recurrences or deaths (median follow-up 17.5 years; 3-30 years). At 15 years, 2 patients of Group 1 experienced biochemical recurrence and they received 100mCi RAI. Three patients of Group 2 experienced recurrence, with 2 receiving 50mCi RAI and 1 undergoing cervical lymph node dissection with 50mCi RAI.CONCLUSIONS:
Patients with low-risk macro-PTC treated by means of near-total thyroidectomy without PCCLND and receiving postoperatively a low dose of 50mCi RAI have excellent long-term prognosis.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Radioterapia
/
Tireoidectomia
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Neoplasias da Glândula Tireoide
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Carcinoma
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Avaliação de Resultados em Cuidados de Saúde
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article