Postoperative Neck Ultrasonography Surveillance After Thyroidectomy in Patients With Medullary Thyroid Carcinoma: A Multicenter Study

Hye Shin Ahn; Dong Wook Kim; Yoo Jin Lee; Chang Yoon Lee; Ji-Hoon Kim; Yoon Jung Choi; Song Lee; Inseon Ryoo; Jung Yin Huh; Jin Yong Sung; Jin Young Kwak; Hye Jin Baek

doi:10.3389/fendo.2018.00102

Postoperative Neck Ultrasonography Surveillance After Thyroidectomy in Patients With Medullary Thyroid Carcinoma: A Multicenter Study

Front Endocrinol (Lausanne). 2018 Mar 15:9:102. doi: 10.3389/fendo.2018.00102. eCollection 2018.

Authors

Hye Shin Ahn¹, Dong Wook Kim², Yoo Jin Lee², Chang Yoon Lee³, Ji-Hoon Kim⁴, Yoon Jung Choi⁵, Song Lee⁶, Inseon Ryoo⁷, Jung Yin Huh⁸, Jin Yong Sung⁹, Jin Young Kwak¹⁰, Hye Jin Baek¹¹

Affiliations

¹ Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea.
² Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.
³ Department of Radiology, Research Institute and Hospital, National Cancer Center, Gyeonggi, South Korea.
⁴ Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
⁵ Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
⁶ Department of Radiology, Chak Han Madi Hospital, Incheon, South Korea.
⁷ Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea.
⁸ Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
⁹ Department of Radiology, Thyroid Center, Daerim St. Mary's Hospital, Seoul, South Korea.
¹⁰ Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea.
¹¹ Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea.

Abstract

Background: For detecting tumor recurrence of medullary thyroid carcinoma (MTC) in the neck, an appropriate frequency and interval of postoperative ultrasonography (US) surveillance remains unclear. This study aimed to assess an appropriate interval and frequency of postoperative neck US surveillance for detecting tumor recurrence in patients who had undergone thyroid surgery due to MTC.

Methods: A total of 86 patients who had undergone thyroid surgery for the treatment of MTC and had at least one postoperative US follow-up examination at any of nine affiliated hospitals were included. Postoperative follow-up US, clinical, and histopathological results of patients were reviewed. The tumor recurrence/persistence rate of MTC was investigated, and the interval and session number of postoperative follow-up US and clinicopathologic factors were compared between tumor recurrence/persistence and non-recurrence groups.

Results: Of the 86 patients, 22 (25.6%) showed tumor recurrence/persistence. Of the 22 patients with tumor recurrence/persistence, 11 (50%) showed structural recurrence/persistence in the neck on follow-up US. In these 11 patients, the mean interval and session number of postoperative follow-up US between initial surgery and the first US detection of recurrence/persistence was 41.3 ± 39.3 months (range, 6-128 months) and 2.6 ± 2.3 (range, 1-8), respectively. On follow-up US, 6 (54.5%, 6/11) were diagnosed with tumor recurrence/persistence within 3 years of the initial surgery. Tumor recurrence/persistence was significantly correlated with TNM stage (p < 0.001) and multiplicity/bilaterality (p = 0.013).

Conclusion: For detecting MTC recurrence/persistence, postoperative US surveillance at 1-year intervals may be sufficient within the first 3 years after thyroid surgery, but depending on the presence of relevant risk factors, annual or biannual US surveillance may be recommendable for 4-10 years after thyroid surgery.

Keywords: malignancy; medullary thyroid carcinoma; recurrence; surveillance; thyroid; ultrasonography.