A total of 157 patients over an 18 year period had a neck re-operation for cure at a single institution in France. Many patients were young (average age was 35 years) and more than 60% were women. More than 2/3 (71%) had previously had a neck dissection as part of their initial operation and 25% of the cancers were of an aggressive type. Immediately after the re-operation, 63% had a complete response and the complication rates of reoperation were low. Of these, at least 25% experienced a second recurrence of their cancer within 5 years. Risk factors for non-cure at re-operation included age > 45 years, aggressive cancer type and a lymph node dissection as part of the initial surgery. Risk factors for a second recurrence included male sex, aggressive cancer type and >10 positive lymph nodes at rep-operation. At long-term follow-up, just overhalf of patients with a first recurrence were free of disease.
WHAT ARE THE IMPLICATIONS OF THIS STUDY?
This study shows that after the first re-operation for persistent or recurrent thyroid cancer, just over 50% were free of disease and apparently cured. This study shows that surgery for an initial recurrence can produce long-lasting cures in many patients and therefore is a good approach to treatment. Moreover, certain risk factors for non-cure were identified that would be important for counseling patients about long-term prognosis.
— Melanie Goldfarb, MD
ATA THYROID BROCHURE LINKS
Thyroid Cancer (Papillary and Follicular): https://www. thyroid.org/thyroid-cancer/
Thyroid Surgery: https://www.thyroid.org/thyroid-surgery/