alexa Oncologic Results of Completion Thyroidectomy and Secondary Prophylactic Lymph Node Dissection in the Management of Differentiated Thyroid Cancer
ISSN: 2167-7948

Journal of Thyroid Disorders & Therapy
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Research Article

Oncologic Results of Completion Thyroidectomy and Secondary Prophylactic Lymph Node Dissection in the Management of Differentiated Thyroid Cancer

Stéphanie Mucci-Hennekine1, Cécile Caillard2, Eric Mirallié3, Olivier Morel4, Patrice Rodien5 and Antoine Hamy6*
1Medical Doctor, Department of Digestive and Endocrine Surgery, University Hospital, Angers, France
2Medical Doctor, Department of Digestive and Endocrine Surgery, University Hospital, Nantes, France
3Professor of Surgery, Department of Digestive and Endocrine Surgery, University Hospital, Nantes, France
4Medical Doctor, Department on Nuclear Medicine, University Hospital, Angers, France
5Professor of Medicine, Department of Endocrinology, University Hospital, Angers, France
6Professor of Surgery, Department of Digestive and Endocrine Surgery, University Hospital, Angers, France
Corresponding Author : Professor Antoine Hamy
Service de Chirurgie Digestive et Endocrinienne, CHU Angers
4 rue Larrey 49933 Angers Cedex 9, France
E-mail: [email protected]
Received July 21, 2012; Accepted August 30, 2012; Published September 01, 2012
Citation: Mucci-Hennekine S, Caillard C, Mirallié E, Morel O, Rodien P, et al. (2012) Oncologic Results of Completion Thyroidectomy and Secondary Prophylactic Lymph Node Dissection in the Management of Differentiated Thyroid Cancer. Thyroid Disorders Ther 1:116. doi:10.4172/2167-7948.1000116
Copyright: © 2012 Mucci-Hennekine S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

The management of differentiated thyroid cancer consists of a total thyroidectomy and cervical lymph node dissection (LND). However, certain patients do not receive this treatment for their first surgery, with a second operation being planned for a completion thyroidectomy and LND. The present study was undertaken to evaluate the morbidity and oncologic results of this two-stage strategy. All patients treated in two surgical stages from January 1992 to June 2009 were included in this study.
A total of 140 patients were included in the analysis. None received a diagnosis of cancer before or during the first surgery. The initial treatment involved 29 total thyroidectomies and 111 lobectomies. All patients had differentiated thyroid cancer. At the second surgery, 111 lobectomies and 140 LND were performed. Morbidity included one haematoma, 30 hypoparathyroidism (six definitive), and 13 nerve palsies (six definitive), while 14 microcarcinomas were diagnosed. In total, 12 patients suffered from lymph node metastases and 24 residual diseases. After a mean follow-up of 59.8 months, four patients had metastases and three elevated thyroglobulin levels, while 133 were disease free. Completion thyroidectomy should be performed on account of the incidence of second cancers, thus allowing for radioactive iodine therapy to be performed. Secondary prophylactic LND has a significant morbidity,
which calls into question its routine recommendation.

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