Results of surgical treatment for recurrent differentiated thyroid cancer at National Hospital of Endocrinology

Abstract

Abstract Introduction: To evaluate the results of surgical treatment for recurrent differentiated thyroid cancer. Patients and methods: Descriptive study of 82 recurrent differentiated thyroid cancer patients underwent re-operated at National Hospital of Endocrinology from 2017 to 2020. Results: Mean age 44.2 ± 12.6 years, female/male = 3.3 / 1. Median recurrence times was 25 months. Patients detected the disease through regular health check was 82.9%. Physical examination revealed lesions 31,7%. Ultrasound revealed lesions 97.6%. Tg positive 81.7%, median 33.2; Anti-Tg positive 20.7%, median 22.6. Whole-body Scintigraphy was positive 47.6%. PET/CT positive 100%. Surgical techniques: Total thyroidectomy + cervical lymph nodes dissection accounted for 9.8%; cervical lymph nodes dissection only accounted for 90.2%. Location of cervical lymph node dissection: Central dissection 18.3%; lateral dissection 51.2%; Central & lateral lymph nodes dissection accounted for 30.5%. The rate of invasion of recurrent block accounted for 23.2%. Complications that occurred during surgery including: major vascular injury 2.4%; laryngeal nerve injury 2.4%, tracheal injury 1.2%, parathyroid glands injury 3.6%, lymphatic vascular injury 6.1% were managed immediately during surgery. Post-surgical complications: bleeding 1.2%; respiratory failure 1.2%; hoarseness 3.6%; Hypocalcemia 11.0%; Hematoma 3.6%; Chyle leak 7.3%, in which 1 case (1.2%) had to have stitches sutured. Vocal fold paralysis after in 3 months later (2.4%) and 1 case hypoparathyroidism (1.2%); Tg positive 70.7%, median 14.3. Anti–Tg positive 13.4%, median 16.2. 18.3% of patients treated with hormone only; 81.7% of patients treated with I131. Conclusion: Surgery is a safe and effective treatment for recurrent differentiated thyroid cancer. Keywords: Recurrent differentiated thyroid cancer, lymph node neck dissection