Neck dissection does not increases the risk of stroke in thyroid cancer: A national cohort study

PLoS One. 2018 Mar 29;13(3):e0195074. doi: 10.1371/journal.pone.0195074. eCollection 2018.

Abstract

Objectives: The purpose of this study is to evaluate the risk of stroke (hemorrhagic or ischemic) after neck dissection in thyroid cancer patients in Korea using national cohort data.

Methods: Using the national cohort study from the Korean Health Insurance Review and Assessment Service, patients with neck dissection for thyroid cancer (1,041) and control participants (4,164) were selected and matched 1:4 (age, gender, income, and region of residence). The Chi-square test, Fischer's exact test, and the Cox-proportional hazard model were used. The Cox-proportional analysis used a crude model and an adjusted model for age, gender, income, region of residence, hypertension, diabetes, dyslipidemia.

Results: None of the participants had suffered hemorrhagic stroke in the neck dissection group, while 0.3% (13/4,164) of participants had suffered hemorrhagic stroke in the control group (P = 0.085). In total, 0.8% (8/1,041) of participants had suffered an ischemic stroke in the neck dissection group, and 0.7% (31/4,133) of participants had suffered an ischemic stroke in the control group (P = 0.936). The adjusted hazard ratio for ischemic stroke after neck dissection was 1.06 (95% confidence interval [CI] = 0.49-2.31, P = 0.884).

Conclusion: The risk of hemorrhagic or ischemic stroke was not higher in thyroid cancer patients who underwent neck dissection than that in the matched control group.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Cohort Studies
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neck Dissection / adverse effects*
  • Postoperative Complications*
  • Prognosis
  • Republic of Korea
  • Risk Factors
  • Stroke / etiology*
  • Thyroid Neoplasms / surgery*
  • Young Adult

Grants and funding

This work was supported in part by research grants from the National Research Foundation (NRF) of Korea (NRF-2015-R1D1A1A01060860), and the Hallym University (HURF-2016-42). There was no additional external funding received for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.