Utility of routine ultrasonography follow-up after total thyroidectomy in patients with papillary thyroid carcinoma: a single-center study

BMC Med Imaging. 2018 May 15;18(1):12. doi: 10.1186/s12880-018-0253-9.

Abstract

Background: This study aimed to assess the appropriate number of sessions and interval of routine follow-up ultrasonography (US) in patients who underwent total thyroidectomy for papillary thyroid carcinoma (PTC).

Methods: Between January 2008 and December 2009, 569 patients underwent total thyroidectomy for PTC. Of the 569 patients, 44 were excluded from the study because of no US follow-up data for the neck (n = 43) or owing to indeterminate tumor recurrence/persistence (n = 1). The follow-up US for all the patients was performed by a single radiologist. Based on the cytohistopathological results, tumor recurrence/persistence was determined.

Results: In the 525 patients, the mean interval to the last follow-up US was 54.7 months, and the mean number of follow-up US sessions was 4.4. Of the 525 patients, 31 (5.9%) showed nodal (n = 30) and non-nodal (n = 1) tumor recurrence/persistence. Patient age and N stage were independently associated with tumor recurrence/persistence. Among patients showing tumor recurrence/persistence after total thyroidectomy, the time at first detection of suspicious US findings on follow-up US was ≤8 months in 2 patients, between 10 and 23 months in 21, and ≥ 25 months in 8. In a receiver operating characteristic curve analysis, the number of sessions and interval of the provided follow-up US were inappropriate for the detection of tumor recurrence/persistence.

Conclusions: For the detection of tumor recurrence/persistence after total thyroidectomy in PTC patients, routine US follow-up with a 1- or 2-year interval may be excessive.

Keywords: Follow-up; Papillary thyroid carcinoma; Recurrence; Surveillance; Total thyroidectomy; Ultrasonography.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Diagnostic Tests, Routine
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnostic imaging*
  • Neoplasm Recurrence, Local / epidemiology
  • ROC Curve
  • Thyroid Cancer, Papillary / diagnostic imaging*
  • Thyroid Cancer, Papillary / epidemiology
  • Thyroid Cancer, Papillary / surgery*
  • Thyroid Gland / diagnostic imaging
  • Thyroid Gland / surgery
  • Thyroid Neoplasms / diagnostic imaging*
  • Thyroid Neoplasms / epidemiology
  • Thyroid Neoplasms / surgery*
  • Thyroidectomy
  • Time Factors
  • Treatment Outcome
  • Ultrasonography
  • Young Adult