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Purpose To delineate risk factors for, and examine temporal patterns of, histology-proven recurrent medullary thyroid cancer (MTC) after compartment-oriented surgery. Methods Multivariate Cox regression on overall, node, and soft tissue infiltrate recurrence per previously dissected neck compartment. Results Mean follow-up for the 203 (and 158) patients with central (and ipsilateral lateral) neck dissection was 56.1 months. On multivariate Cox regression, tumor size > 20 mm predicted overall and node recurrence in the central neck, whereas extranodal growth predicted overall and node recurrence in the ipsilateral lateral neck. Extrathyroidal extension alone predicted soft tissue infiltrate recurrence in the central neck, and extranodal growth alone soft tissue infiltrate recurrence in the ipsilateral lateral neck. When analyses were restricted to patients not biochemically cured after initial surgery, only extranodal growth predicted overall and node recurrence in the dissected neck compartments. Conclusions Patients not biochemically cured, specifically those with extranodal growth at the initial operation, carry greater risks of node recurrence. ● ● ● Keywords Medullary thyroid carcinoma Lymph node metastasis Compartment-oriented neck dissection Node recurrence Soft tissue infiltrate recurrence Introduction ipsilateral lateral neck, whereas involvement of the con- tralateral lateral neck or the upper anterior mediastinum is Medullary thyroid cancer (MTC), a
Endocrine – Springer Journals
Published: Jun 5, 2018
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