Document Detail


Evaluation of the surgical completeness after total thyroidectomy for differentiated thyroid carcinoma.
MedLine Citation:
PMID:  17433606     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article     Date:  2007-04-12
Journal Detail:
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:
Created Date:  2007-05-21     Completed Date:  2007-07-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8504356     Medline TA:  Eur J Surg Oncol     Country:  England    
Other Details:
Languages:  eng     Pagination:  648-54     Citation Subset:  IM    
Affiliation:
Institute of Nuclear Medicine, Università Cattolica del S. Cuore, Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
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:
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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