Long-term results of surgery for papillary thyroid carcinoma with local recurrence

• Published in: Surgery today (Tokyo, Japan) Vol. 43; no. 8; pp. 848 - 853
• Main Authors: Uchida, Hiroki, Imai, Tsuneo, Kikumori, Toyone, Hayashi, Hironori, Sato, Shigenori, Noda, Sumiyo, Idota, Ai, Kiuchi, Tetsuya
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.08.2013
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Carcinoma, Papillary - mortality; Carcinoma, Papillary - surgery; Child; Cohort Studies; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - surgery; Original Article; Reoperation; Retrospective Studies; Sex Factors; Surgery; Surgical Oncology; Survival Rate; Thyroid Neoplasms - mortality; Thyroid Neoplasms - surgery; Thyroidectomy - methods; Thyroidectomy - mortality; Time Factors; Young Adult; Papillary; Reoperation; Recurrence; Complication; Thyroid carcinoma; Follow-up
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-012-0353-z

Purpose Surgical treatment of local recurrent papillary thyroid carcinoma is still controversial because of the increased morbidity in comparison to primary surgery, and the unclear efficacy. This study analyzed the efficacy and safety of surgery for recurrent disease. Methods A retrospective cohort analysis of 86 patients who underwent surgery for local recurrent papillary thyroid carcinoma at a single institution during the period 1979–2009. Results The cause-specific survival rates of all patients at 5, 10, and 20 years were 86 % (95 % CI 77–95 %), 74 % (95 % CI 62–87 %), and 36 % (95 % CI 18–54 %), respectively. A univariate analysis found that gender, age >45 years at reoperation and macroscopic non-curative surgery for recurrence affected the cause-specific survival rates. The latter two features remained significant in a multivariate analysis. Permanent recurrent nerve paralysis and hypoparathyroidism developed in 4 (4.7 %) and 5 (5.8 %) patients, respectively. Conclusions Surgery for local recurrent papillary thyroid carcinoma could be effective when macroscopic curative dissection was possible, and that the procedure was safe and was associated with minimal morbidity. Therefore, repeat surgery for local recurrent papillary thyroid carcinoma is worthwhile.