| Evaluation of the surgical completeness after total thyroidectomy for differentiated thyroid carcinoma. | |
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MedLine Citation:
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PMID: 17433606 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: To quantify the rate of patients without thyroid remnants, to identify predictive factors for the absence of residual thyroid tissue and to evaluate number, site, size and function of thyroid remnants after total thyroidectomy for differentiated thyroid carcinoma (DTC). METHODS: Thousand one hundred and seventy-eight patients who underwent total thyroidectomy for DTC were evaluated; 343 patients with lymph node or distant metastases and 115 patients with detectable thyroglobulin autoantibodies (TgAb) were excluded. (131)I ablative treatment (RAI) without preliminary diagnostic (131)I whole body scans (DxWBS), and 24-h (131)I quantitative neck uptake (RAIU test) and thyroglobulin (Tg) off L-T4 evaluation were performed in the remaining 720 pts. In 252 patients a 99mTc-pertechnetate pre-operative thyroid scan (99mTc-scan) was used for comparison with (131)I neck scans after RAI to evaluate site of thyroid remnants. Only patients with thyroid remnants were evaluated for successful ablation 6-10 months after RAI. RESULTS: Post-treatment whole body scan (TxWBS) demonstrated lack of thyroid remnants in 50/720 patients and the best predictive factors for the absence of residual thyroid tissue were RAIU <1% and undetectable Tg off L-T4. Thyroid remnants were present in 670/720 patients. In 252 patients with (99m)Tc-scan, 617 sites of functioning thyroid tissue were found: 381 within and 236 outside the thyroid bed. Complete successful ablation was achieved in 610/670 patients with thyroid remnants. CONCLUSIONS: This study confirms that most patients (93.1%) have thyroid remnant after total thyroidectomy for DTC. Most thyroid remnants were contralateral to tumour site and were even observed outside thyroid bed. However, a real total thyroidectomy, demonstrated by negative TxWBS, RAIU <1% and undetectable Tg off L-T4, was achieved in 6.9% of patients. |
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Authors:
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M Salvatori; M Raffaelli; P Castaldi; G Treglia; V Rufini; G Perotti; C P Lombardi; D Rubello; G Ardito; R Bellantone |
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Publication Detail:
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Type: Journal Article Date: 2007-04-12 |
Journal Detail:
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Title: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology Volume: 33 ISSN: 0748-7983 ISO Abbreviation: Eur J Surg Oncol Publication Date: 2007 Jun |
Date Detail:
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Created Date: 2007-05-21 Completed Date: 2007-07-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8504356 Medline TA: Eur J Surg Oncol Country: England |
Other Details:
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Languages: eng Pagination: 648-54 Citation Subset: IM |
Affiliation:
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Institute of Nuclear Medicine, Università Cattolica del S. Cuore, Rome, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Child Female Follow-Up Studies Humans Iodine Radioisotopes / diagnostic use Male Middle Aged Thyroglobulin / analysis Thyroid Function Tests Thyroid Neoplasms / surgery* Thyroidectomy / methods* Thyrotropin / analysis |
| Chemical | |
Reg. No./Substance:
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0/Iodine Radioisotopes; 9002-71-5/Thyrotropin; 9010-34-8/Thyroglobulin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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