Histology-proven recurrence in the lateral or central neck after systematic neck dissection for medullary thyroid cancer

Abstract

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.

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