RECURRENCE
OF PAPILLARY THYROID CANCER IN CERVICAL LYMPH NODES FOLLOWING INITIAL THERAPY;
RADIOIODINE ABLATION THERAPY OR SURGERY?
Patients
with recurrence of PTC in the lymph nodes of the neck often have a negative
follow-up diagnostic whole-body radioiodine scan after initial therapy (total
thyroidectomy with or without lymph node dissection). These patients probably
will not benefit from additional radioiodine treatment. Surgical reintervention
is more likely to render them free of disease than repeat empirical radioiodine
therapy. However, failure to resect involved lymph nodes during repeat surgery
in the neck is relatively high (~ 10 %), and this is more common when lymph
nodes are small (< 6 - 8 mm) and when a lymph node dissection has previously
been performed. Small ultrasonographically suspicious lymph nodes (< 8 – 10 mm)
MAY be followed without surgery; in this case, surgery should be considered if
there is growth or if the involved node threatens adjacent vital anatomic
structure(-s).
Σχόλια
Δημοσίευση σχολίου