Document Detail


Approach and safety of comprehensive central compartment dissection in patients with recurrent papillary thyroid carcinoma.
MedLine Citation:
PMID:  19360746     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Despite the generally favorable prognosis of patients with papillary thyroid cancers, 10-year recurrence rates for patients with stage I to III disease is greater than 20%, with central compartment recurrences common among these recurrent sites. METHODS: This study is a retrospective analysis of consecutive patients treated by a single surgeon over an 18-month period of time terminating in 2003. RESULTS: Sixty-three patients underwent a comprehensive dissection of levels VI and VII for papillary thyroid carcinoma during this period. There was a female predominance of 2:1, with 48% of patients being greater than 45 years of age. The median number of lymph nodes identified was 16 (range, 3-52), with 7 (1-20) lymph nodes pathologically involved. Permanent hypoparathyroidism was present on presentation in 13% of patients and developed in an additional 5% following surgery. Although recurrent laryngeal paralysis was present on presentation among 8 (13%) of patients, no patients experienced paralysis of documented functioning recurrent laryngeal nerves or necessitated tracheotomy. Postoperative thyroglobulin levels were reduced to nondetectable in 71% of the informative cases. Over 60% of patients were discharged on their first postoperative day. CONCLUSION: Bilateral paratracheal and superior mediastinal dissection is an oncologically safe procedure exhibiting minimal morbidity when performed among experienced individuals despite multiple prior surgical procedures or existing vocal cord paralysis.
Authors:
Gary L Clayman; Thomas D Shellenberger; Lawrence E Ginsberg; Beth S Edeiken; Adel K El-Naggar; Rena V Sellin; Steven G Waguespack; Dianna B Roberts; Anupam Mishra; Steven I Sherman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Head & neck     Volume:  31     ISSN:  1097-0347     ISO Abbreviation:  Head Neck     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-13     Completed Date:  2009-10-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8902541     Medline TA:  Head Neck     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1152-63     Citation Subset:  IM    
Affiliation:
Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. gclayman@mdanderson.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Carcinoma, Papillary / pathology,  surgery*
Female
Humans
Lymph Node Excision*
Lymphatic Metastasis
Male
Middle Aged
Neck Dissection*
Neoplasm Recurrence, Local / surgery*
Thyroid Neoplasms / pathology,  surgery*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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