Analysis of postoperative ultrasonography surveillance after total thyroidectomy in patients with papillary thyroid carcinoma: a multicenter study.
Background In papillary thyroid carcinoma (PTC) patients, postoperative ultrasonography (US) surveillance is recommended at intervals of six or 12 months even though evidence is weak. Purpose To determine the optimal interval of postoperative US surveillance in patients after total thyroidectomy for the treatment of PTC using multicenter data. Material and Methods A total of 1400 patients from seven tertiary hospitals who underwent total thyroidectomy for treatment of PTC were included. Based on a retrospective review of clinical and pathologic results, multiple factors were analyzed according to recurrence/persistence or no recurrence/persistence. In recurrence/persistence group, the interval and number of follow-up US sessions in the initial detection of recurrence/persistence were investigated. Results Of the 1400 patients, 115 (8.2%) showed tumor recurrence/persistence on follow-up US. Of 115 recurrence/persistence cases, 89 (77.4%) were initially detected on US: nodal recurrence/persistence (n = 92), non-nodal recurrence/persistence (n = 22), and both (n = 1). Among the clinical and pathologic factors, only tumor size and N stage were significant predictors for recurrence/persistence. In the recurrence/persistence group, the mean interval and number of follow-up US sessions in the initial detection of recurrence/persistence was 22.3 ± 16.8 months and 2.2 ± 1.9, respectively. Approximately two-thirds of recurrence/persistence cases (76/115, 66.1%) were detected in follow-up US within two years after total thyroidectomy. Conclusion In PTC patients after total thyroidectomy, the optimal interval of the first US follow-up may be one to two years after thyroid surgery, and the appropriate number of postoperative US surveillance sessions within the first five years may be only one or two.
1 Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Inseon
I
Ryoo
2 Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Dong Wook
DW
Kim
3 Department of Radiology, Research Institute and Hospital, National Cancer Center, Gyeonggi, Republic of Korea.
Chang Yoon
CY
Lee
4 Department of Radiology, CHA University College of Medicine, Gangnam CHA Hospital, Seoul, Republic of Korea.
Jung Yin
JY
Huh
5 Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Song
S
Lee
6 Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
Hye Shin
HS
Ahn
7 Department of Radiology, Thyroid Center, Daerim St. Mary's Hospital, Seoul, Republic of Korea.
Jin Yong
JY
Sung
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010212:Papilloma / Q000473:pathology / Q000601:surgery*; D011184:Postoperative Period; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy; D013997:Time Factors; D014463:Ultrasonography
Thyroid; papillary thyroid carcinoma; recurrence; total thyroidectomy; ultrasonography