open access

Vol 57, No 4 (2006)
Original papers
Published online: 2006-07-07
Submitted: 2013-02-15
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Completion total thyroidectomy in children with differentiated thyroid cancer

Daria Handkiewicz-Junak, Jan Włoch, Agnieszka Czarniecka, Józef Roskosz, Andrzej Prokurat, Lech Pomorski, Jolanta Krajewska, Aleksandra Kropińska, Aleksandra Kukulska, Barbara Jarząb
Endokrynologia Polska 2006;57(4):356-361.

open access

Vol 57, No 4 (2006)
Original papers
Published online: 2006-07-07
Submitted: 2013-02-15

Abstract

Introduction: The optimal surgical treatment of children with differentiated thyroid cancer remains an important point of discussion. Especially the need for completion operation is questioned in young patients. Our objective was to examine the rate of residual neoplastic disease after non radical initial operation.
Material and methods: From the 235 children diagnosed with differentiated thyroid cancer, 131 (56%) needed completion operation due to incomplete primary surgery. Completion operation involved thyroid bed, lymph nodes or both respectively in 91 (39%), 13 (6%) and 27 (11%) cases. Risk factors responsible for residual disease were evaluated by means of logistic regression analysis.
Results: Residual disease was detected in 46 (35%) of reoperated children (25% in thyroid bed and 85% in lymph node of lateral neck compartment). Sex and age did not influence the risk of residual disease in thyroid bed or lymph nodes. Papillary type of cancer and multifocality increased risk of residual disease in thyroid bed respectively by the factor of 15 (95% CI: 2-125) and 2.3 (95% CI: 1.2-4.4). Infiltration of thyroid capsule did not correlate with the risk of residual disease. Lymph node metastases in primary operation increased risk of residual disease by the factor of 16 (95% CI: 1.2-245). Histopathology, multifocality of primary tumour or infiltration of lymph node capsule did not influence the risk of residual disease in lymph nodes of lateral neck compartment.
Conclusions: In children with differentiated thyroid cancer residual disease is diagnosed in about 1/3 of non radically operated cases. This high incidence justifies completion operations. The risk of residual disease is significantly increased in papillary thyroid cancer, multifocal tumours and cases with lymph node metastases.

Abstract

Introduction: The optimal surgical treatment of children with differentiated thyroid cancer remains an important point of discussion. Especially the need for completion operation is questioned in young patients. Our objective was to examine the rate of residual neoplastic disease after non radical initial operation.
Material and methods: From the 235 children diagnosed with differentiated thyroid cancer, 131 (56%) needed completion operation due to incomplete primary surgery. Completion operation involved thyroid bed, lymph nodes or both respectively in 91 (39%), 13 (6%) and 27 (11%) cases. Risk factors responsible for residual disease were evaluated by means of logistic regression analysis.
Results: Residual disease was detected in 46 (35%) of reoperated children (25% in thyroid bed and 85% in lymph node of lateral neck compartment). Sex and age did not influence the risk of residual disease in thyroid bed or lymph nodes. Papillary type of cancer and multifocality increased risk of residual disease in thyroid bed respectively by the factor of 15 (95% CI: 2-125) and 2.3 (95% CI: 1.2-4.4). Infiltration of thyroid capsule did not correlate with the risk of residual disease. Lymph node metastases in primary operation increased risk of residual disease by the factor of 16 (95% CI: 1.2-245). Histopathology, multifocality of primary tumour or infiltration of lymph node capsule did not influence the risk of residual disease in lymph nodes of lateral neck compartment.
Conclusions: In children with differentiated thyroid cancer residual disease is diagnosed in about 1/3 of non radically operated cases. This high incidence justifies completion operations. The risk of residual disease is significantly increased in papillary thyroid cancer, multifocal tumours and cases with lymph node metastases.
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Keywords

completion total thyroidectomy; differentiated thyroid cancer; children

About this article
Title

Completion total thyroidectomy in children with differentiated thyroid cancer

Journal

Endokrynologia Polska

Issue

Vol 57, No 4 (2006)

Pages

356-361

Published online

2006-07-07

Bibliographic record

Endokrynologia Polska 2006;57(4):356-361.

Keywords

completion total thyroidectomy
differentiated thyroid cancer
children

Authors

Daria Handkiewicz-Junak
Jan Włoch
Agnieszka Czarniecka
Józef Roskosz
Andrzej Prokurat
Lech Pomorski
Jolanta Krajewska
Aleksandra Kropińska
Aleksandra Kukulska
Barbara Jarząb

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