Surgical resection of recurrent differentiated thyroid cancer: patterns, detection, staging, and treatment of 683 patients
BackgroundDespite improvements in overall survival, the recurrence of differentiated thyroid cancer (DTC) is becoming more common and remains a challenge necessitating accurate reappraisal of the patient. This study aimed to describe the characteristics, reasons, morbidity, and strategies of second...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1301620/full |
| _version_ | 1797403233326465024 |
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| author | Nan Liang Han Zhang Chengqiu Sui Rui Du Canxiao Li Jingting Li Gianlorenzo Dionigi Daqi Zhang Hui Sun |
| author_facet | Nan Liang Han Zhang Chengqiu Sui Rui Du Canxiao Li Jingting Li Gianlorenzo Dionigi Daqi Zhang Hui Sun |
| author_sort | Nan Liang |
| collection | DOAJ |
| description | BackgroundDespite improvements in overall survival, the recurrence of differentiated thyroid cancer (DTC) is becoming more common and remains a challenge necessitating accurate reappraisal of the patient. This study aimed to describe the characteristics, reasons, morbidity, and strategies of second operations for DTC.MethodsThis was a retrospective observational study of patients with DTC who underwent a second surgery between June 2008 and June 2021 in the Department of Thyroid Surgery at China–Japanese Union Hospital, Jilin University, P.R. China. All clinical characteristics were recorded, and the analysis was estimated using SPSS.ResultsSecond surgeries were detected in 683 patients. The proportion of second operations changed with the update of international guidelines from 2015 (P < 0.001). The true recurrence rate progressively increased from 21.3% to 61.5%. The rate of an “absence of preoperative FNA” or an “absence of intraoperative pathology at first surgery” decreased from 49.8% to 12.7%, while that of a “misdiagnosis of preoperative FNA at second surgery” decreased from 10% to 1.8%. The most common tumor location during the second surgery was the lateral lymph nodes (n = 104, 36.5%), with a median time to relapse of 36 months. Completion of thyroidectomy and lymph node dissection correlated with the second operation.ConclusionAfter 2015, second surgeries were more standardized, the incidence of complications decreased, and real recurrence became the most common reason for a second DTC surgery. |
| first_indexed | 2024-03-09T02:35:36Z |
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| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-09T02:35:36Z |
| publishDate | 2023-12-01 |
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| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-8c93f8c0af334fe0a1a34680e1bb39b82023-12-06T08:35:21ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-12-011410.3389/fendo.2023.13016201301620Surgical resection of recurrent differentiated thyroid cancer: patterns, detection, staging, and treatment of 683 patientsNan Liang0Han Zhang1Chengqiu Sui2Rui Du3Canxiao Li4Jingting Li5Gianlorenzo Dionigi6Daqi Zhang7Hui Sun8Division of Thyroid Surgery, The China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun, Jilin, ChinaDivision of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, ChinaDivision of Thyroid Surgery, The China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun, Jilin, ChinaDivision of Thyroid Surgery, The China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun, Jilin, ChinaDivision of Thyroid Surgery, The China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun, Jilin, ChinaDivision of Thyroid Surgery, The China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun, Jilin, ChinaDepartment of Medical Biotechnology and Translational Medicine, Division of General and Endocrine Surgery, Istituto Auxologico Italiano IRCCS, University of Milan, Milan, ItalyDivision of Thyroid Surgery, The China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun, Jilin, ChinaDivision of Thyroid Surgery, The China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun, Jilin, ChinaBackgroundDespite improvements in overall survival, the recurrence of differentiated thyroid cancer (DTC) is becoming more common and remains a challenge necessitating accurate reappraisal of the patient. This study aimed to describe the characteristics, reasons, morbidity, and strategies of second operations for DTC.MethodsThis was a retrospective observational study of patients with DTC who underwent a second surgery between June 2008 and June 2021 in the Department of Thyroid Surgery at China–Japanese Union Hospital, Jilin University, P.R. China. All clinical characteristics were recorded, and the analysis was estimated using SPSS.ResultsSecond surgeries were detected in 683 patients. The proportion of second operations changed with the update of international guidelines from 2015 (P < 0.001). The true recurrence rate progressively increased from 21.3% to 61.5%. The rate of an “absence of preoperative FNA” or an “absence of intraoperative pathology at first surgery” decreased from 49.8% to 12.7%, while that of a “misdiagnosis of preoperative FNA at second surgery” decreased from 10% to 1.8%. The most common tumor location during the second surgery was the lateral lymph nodes (n = 104, 36.5%), with a median time to relapse of 36 months. Completion of thyroidectomy and lymph node dissection correlated with the second operation.ConclusionAfter 2015, second surgeries were more standardized, the incidence of complications decreased, and real recurrence became the most common reason for a second DTC surgery.https://www.frontiersin.org/articles/10.3389/fendo.2023.1301620/fullthyroid cancerrecurrencesurgerymorbiditysecond surgery |
| spellingShingle | Nan Liang Han Zhang Chengqiu Sui Rui Du Canxiao Li Jingting Li Gianlorenzo Dionigi Daqi Zhang Hui Sun Surgical resection of recurrent differentiated thyroid cancer: patterns, detection, staging, and treatment of 683 patients Frontiers in Endocrinology thyroid cancer recurrence surgery morbidity second surgery |
| title | Surgical resection of recurrent differentiated thyroid cancer: patterns, detection, staging, and treatment of 683 patients |
| title_full | Surgical resection of recurrent differentiated thyroid cancer: patterns, detection, staging, and treatment of 683 patients |
| title_fullStr | Surgical resection of recurrent differentiated thyroid cancer: patterns, detection, staging, and treatment of 683 patients |
| title_full_unstemmed | Surgical resection of recurrent differentiated thyroid cancer: patterns, detection, staging, and treatment of 683 patients |
| title_short | Surgical resection of recurrent differentiated thyroid cancer: patterns, detection, staging, and treatment of 683 patients |
| title_sort | surgical resection of recurrent differentiated thyroid cancer patterns detection staging and treatment of 683 patients |
| topic | thyroid cancer recurrence surgery morbidity second surgery |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1301620/full |
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