Authors: Don Yoo Saad Ajmal Shilpa Gowda Jason Machan Jack Monchik Peter Mazzaglia
Publish Date: 2012/03/20
Volume: 36, Issue: 6, Pages: 1255-1261
Abstract
In patients with welldifferentiated thyroid cancer the incidence of pathologic central compartment lymph node metastases is reported to be approximately 50 Recently level VI lymph node dissection has been advocated as a means of reducing recurrence rates in these patients even if there are no clinically apparent nodal metastases This study investigates whether level VI lymph node dissection decreases the percent radioiodine uptake when patients undergo radioiodine ablationAll thyroid cancer patients entered into the endocrine surgery database at a tertiary care center from 2006 to 2010 were reviewed Those treated with radioactive iodine were analyzed with respect to performance of a central compartment lymph node dissection and the percent uptake of radioiodine 131I on the preablation scan at 72 hThere were 277 patients with welldifferentiated thyroid cancer who underwent radioiodine ablation In all 75 were female and the mean age was 477 years A total of 87 patients underwent total thyroidectomy and level VI lymph node dissection TT + LVIND The mean number of level VI nodes resected was 6 1–27 and 609 of patients had nodal metastases Altogether 190 had a total thyroidectomy TT only and the median number of nodes resected was 0 0–10 The percent uptake of radioiodine on the preablation scan was 093 in patients who had undergone TT + LVIND and 12 in those with TT alone p = 017 The median number of radioactive foci noted within the thyroid bed was two in both groups p = 064 The mean preablation thyroglobulin levels measured after thyroxine withdrawal or thyrogen stimulation were 40 ng/ml in the TT + LVIND group versus 47 ng/ml in the TT group p = 007 The average ablative dose of 131I was 1118 mCi in the dissection group and 985 mCi in the TTonly group
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