All patients had a specialized thyroid scan right before and after radioactive iodine therapy to look for persistent abnormal lymph nodes after surgery. PMID: 29562827.Ī total of 352 patients with intermediate or high-risk thyroid cancer treated with total thyroidectomy, +/- some form of neck dissection, and radioactive iodine therapy at a single institution were reviewed. Miller JE et al 2018 Location and causation of residual lymph node metastases after surgical treatment of regionally advanced differentiated thyroid cancer. This study’s aim was to identify the most common location of persistent lymph node cancer as well as the primary reason why there remained cancer in patients with intermediate and high risk thyroid cancer. Despite recommendations for patients with known lymph node involvement to have ‘compartment-oriented’ lymph node dissections (all of the lymph nodes in a given area removed, not ‘berrypicking’ of individual nodes), persistent or residual cancer in lymph nodes is the most common cause of recurrent thyroid cancer. Up to 50% of patients with intermediate-high risk thyroid cancer have clinically meaningful cancer that has spread to the lymph nodes at the time of surgery. There are 3 risk levels based on the risk of cancer recurrence: low, intermediate and high. Indeed, when talking about risk in patients with thyroid cancer, it is risk of cancer recurrence rather than risk of death that is discussed. While spread of the cancer to the lymph nodes in the neck is common at the time of surgery, the prognosis is usually excellent. Thyroid cancer is the fastest rising cancer in women.
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