Department of Surgery, College of Medicine, Pusan National University, Pusan, Korea.
ABSTRACT
PURPOSE: The author performed this study to find factors influencing the locoregional recurrence in papillary thyroid carcinoma (PTC) with reference to the adequacy of initial treatment.
MATERIALS AND METHODS: Records of 13 patients who had received a surgical therapy for locoregional recurrence of PTC at Pusan National University Hospital between January 1993 and December 1996 were analyzed retrospectively.
RESULTS: Twelve patients received the surgery after initial recurrence, while one patient after the 2nd recurrence. At the time of initial surgical therapy, mean age of patients was 51.4 years; 10 patients (76.9%) were female; PTC was documented preor intraoperatively in 3 patients (23.1%); 1 patient (7.7%) had a combined preoperative ultrasonography and computed tomography (CT) of the neck; mode of operation was lobectomy in 9 patients (69.2%), total thyroidectomy in 2 patients (15.4%) and total thyroidectomy with neck dissection in 2 patients (15.4%). At the time of second surgical therapy, pattem of recurrence was regional in 7 patients (53.8%), combined locoregional in 4 patients 30.8%) and local in 2 patient (15.4%); mode of operation was complete thyroidectomy with neck dissection in 9 patients (69.2%), neck dissection in 2 patients (15.4%), and local excision in 2 patients (15.4%). Final outcome of patients (mean follow-up period, 2.8 years) was successful in 6 patients (46.2.%).
CONCLUSION: The data suggest that many cases of locoregional recurrence in PTC occur as a consequence of poor initial therapy. A combined thyroid ultrasonography and neck CT is recommended as a routine preoperative check during initial therapy. The author believes that a total thyroidectomy is the surgical procedure of choice, which facilitates postoperative I therapy.
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