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Postoperative ultrasound unnecessary in papillary thyroid microcarcinoma

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May 11, 2017

Adults with papillary thyroid microcarcinoma who underwent hemithyroidectomy may not need follow-up postoperative ultrasound imaging at 1- or 2-year intervals due to the low recurrence rates, according to published findings.

Dong Wook Kim, MD, of the department of radiology, Busan Paik Hospital, Inje University College of Medicine in South Korea, and colleagues evaluated data from 800 adults (mean age, 43.9 years) who underwent hemithyroidectomy for papillary thyroid microcarcinoma between 2000 and 2011 to determine the prevalence of tumor recurrence/persistence and suitability of postoperative ultrasound surveillance.

Most participants did not exhibit tumor recurrence/persistence on follow-up ultrasound (98%); mean number of follow-up ultrasound sessions for this group was 6.7, and mean interval to the last follow-up ultrasound was 77.3 months. Tumor recurrence/persistence was found in 16 participants, 12 of whom had non-nodal recurrence/persistence; mean number of follow-up ultrasound sessions for this group was 9.4, and mean interval to last follow-up ultrasound was 95.6 months. Researchers observed no differences between participants who did and did not develop tumor recurrence/persistence in terms of primary tumor size, T stage, N stage, M stage, tumor location or type of hemithyroidectomy.

The mean largest diameter of a suspicious lesion on follow-up ultrasound was 5.3 mm in all participants with tumor recurrence/persistence. Ultrasound features were similar to those of primary papillary thyroid microcarcinoma in participants with non-nodal recurrence/persistence. The mean interval of postoperative follow-up ultrasound until detection of recurrence/persistence was 42.9 months, and mean number of follow-up sessions was 2.4.

“This multicenter study, involving a large series of patients who underwent hemithyroidectomy for [papillary thyroid microcarcinoma], demonstrated that the tumor recurrence/persistence rate was low, and that the interval range for post-hemithyroidectomy follow-up [ultrasound] for the detection of tumor recurrence/persistence was variable,” the researchers wrote. “Although all cases of tumor recurrence/persistence were detected on follow-up [ultrasound] after hemithyroidectomy for [papillary thyroid microcarcinoma], this does not warrant the use of postoperative [ultrasound] surveillance at 1- or 2-year intervals. We believe that a single session of postoperative [ultrasound] surveillance is sufficient to detect tumor recurrence/persistence within the first 5 years after hemithyroidectomy for [papillary thyroid microcarcinoma].” – by Amber Cox

Disclosure: The researchers report no relevant financial disclosures.

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