Radioactive iodine remnant uptake after completion thyroidectomy

Not such a complete cancer operation

Sarah C. Oltmann, David F. Schneider, Glen Leverson, Tamilselvan Sivashanmugam, Herbert Chen, Rebecca S. Sippel

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background. Given limitations in preoperative diagnostics, thyroid lobectomy followed by completion thyroidectomy (CT) for differentiated thyroid cancer (DTC) may be required. It is unclear whether resection quality by CT differs from that by total thyroidectomy (TT). Additional surgeon or patient factors may also influence the "completeness" of resection. This study evaluated how CT and surgeon volume influence the adequacy of resection as measured by radioactive iodine (RAI) remnant uptake. Methods. A retrospective review of a prospectively collected thyroid database was queried for patients treated for DTC with TT or CT followed by RAI ablation. CT patients were matched 1:2 by age, sex, and tumor size to TT patients. Surgeon volume, time to completion, and continuity of surgeon care were reviewed. Results. Over 18 years, 45 patients with DTC had CT and RAI. Mean age was 48 ± 2 years, and 76 % were female, with a tumor size of 2.7 ± 0.3 cm. CT had higher remnant uptake than TT (0.07 vs. 0.04 %; p = 0.04). CT performed by a high-volume surgeon had much lower remnant uptakes (0.06 vs. 0.22 %; p = 0.04). Remnant uptake followed a stepwise decrease with involvement of a high-volume surgeon for part or all of the surgical management (p = 0.11). Multiple regression analysis found CT (p = 0.02) and surgeon volume (p = 0.04) to significantly influence uptake after controlling for other factors. Conclusions. Single-stage TT provides a better resection based on smaller thyroid remnant uptakes than CT for patients with thyroid cancer. If a staged operation for cancer is necessary, surgeon volume may affect the completeness of resection.

Original languageEnglish (US)
Pages (from-to)1379-1383
Number of pages5
JournalAnnals of Surgical Oncology
Volume21
Issue number4
DOIs
StatePublished - 2014

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Thyroidectomy
Iodine
Neoplasms
Thyroid Neoplasms
Thyroid Gland
Continuity of Patient Care
Surgeons

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Radioactive iodine remnant uptake after completion thyroidectomy : Not such a complete cancer operation. / Oltmann, Sarah C.; Schneider, David F.; Leverson, Glen; Sivashanmugam, Tamilselvan; Chen, Herbert; Sippel, Rebecca S.

In: Annals of Surgical Oncology, Vol. 21, No. 4, 2014, p. 1379-1383.

Research output: Contribution to journalArticle

Oltmann, Sarah C. ; Schneider, David F. ; Leverson, Glen ; Sivashanmugam, Tamilselvan ; Chen, Herbert ; Sippel, Rebecca S. / Radioactive iodine remnant uptake after completion thyroidectomy : Not such a complete cancer operation. In: Annals of Surgical Oncology. 2014 ; Vol. 21, No. 4. pp. 1379-1383.
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abstract = "Background. Given limitations in preoperative diagnostics, thyroid lobectomy followed by completion thyroidectomy (CT) for differentiated thyroid cancer (DTC) may be required. It is unclear whether resection quality by CT differs from that by total thyroidectomy (TT). Additional surgeon or patient factors may also influence the {"}completeness{"} of resection. This study evaluated how CT and surgeon volume influence the adequacy of resection as measured by radioactive iodine (RAI) remnant uptake. Methods. A retrospective review of a prospectively collected thyroid database was queried for patients treated for DTC with TT or CT followed by RAI ablation. CT patients were matched 1:2 by age, sex, and tumor size to TT patients. Surgeon volume, time to completion, and continuity of surgeon care were reviewed. Results. Over 18 years, 45 patients with DTC had CT and RAI. Mean age was 48 ± 2 years, and 76 {\%} were female, with a tumor size of 2.7 ± 0.3 cm. CT had higher remnant uptake than TT (0.07 vs. 0.04 {\%}; p = 0.04). CT performed by a high-volume surgeon had much lower remnant uptakes (0.06 vs. 0.22 {\%}; p = 0.04). Remnant uptake followed a stepwise decrease with involvement of a high-volume surgeon for part or all of the surgical management (p = 0.11). Multiple regression analysis found CT (p = 0.02) and surgeon volume (p = 0.04) to significantly influence uptake after controlling for other factors. Conclusions. Single-stage TT provides a better resection based on smaller thyroid remnant uptakes than CT for patients with thyroid cancer. If a staged operation for cancer is necessary, surgeon volume may affect the completeness of resection.",
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T2 - Not such a complete cancer operation

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AU - Schneider, David F.

AU - Leverson, Glen

AU - Sivashanmugam, Tamilselvan

AU - Chen, Herbert

AU - Sippel, Rebecca S.

PY - 2014

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N2 - Background. Given limitations in preoperative diagnostics, thyroid lobectomy followed by completion thyroidectomy (CT) for differentiated thyroid cancer (DTC) may be required. It is unclear whether resection quality by CT differs from that by total thyroidectomy (TT). Additional surgeon or patient factors may also influence the "completeness" of resection. This study evaluated how CT and surgeon volume influence the adequacy of resection as measured by radioactive iodine (RAI) remnant uptake. Methods. A retrospective review of a prospectively collected thyroid database was queried for patients treated for DTC with TT or CT followed by RAI ablation. CT patients were matched 1:2 by age, sex, and tumor size to TT patients. Surgeon volume, time to completion, and continuity of surgeon care were reviewed. Results. Over 18 years, 45 patients with DTC had CT and RAI. Mean age was 48 ± 2 years, and 76 % were female, with a tumor size of 2.7 ± 0.3 cm. CT had higher remnant uptake than TT (0.07 vs. 0.04 %; p = 0.04). CT performed by a high-volume surgeon had much lower remnant uptakes (0.06 vs. 0.22 %; p = 0.04). Remnant uptake followed a stepwise decrease with involvement of a high-volume surgeon for part or all of the surgical management (p = 0.11). Multiple regression analysis found CT (p = 0.02) and surgeon volume (p = 0.04) to significantly influence uptake after controlling for other factors. Conclusions. Single-stage TT provides a better resection based on smaller thyroid remnant uptakes than CT for patients with thyroid cancer. If a staged operation for cancer is necessary, surgeon volume may affect the completeness of resection.

AB - Background. Given limitations in preoperative diagnostics, thyroid lobectomy followed by completion thyroidectomy (CT) for differentiated thyroid cancer (DTC) may be required. It is unclear whether resection quality by CT differs from that by total thyroidectomy (TT). Additional surgeon or patient factors may also influence the "completeness" of resection. This study evaluated how CT and surgeon volume influence the adequacy of resection as measured by radioactive iodine (RAI) remnant uptake. Methods. A retrospective review of a prospectively collected thyroid database was queried for patients treated for DTC with TT or CT followed by RAI ablation. CT patients were matched 1:2 by age, sex, and tumor size to TT patients. Surgeon volume, time to completion, and continuity of surgeon care were reviewed. Results. Over 18 years, 45 patients with DTC had CT and RAI. Mean age was 48 ± 2 years, and 76 % were female, with a tumor size of 2.7 ± 0.3 cm. CT had higher remnant uptake than TT (0.07 vs. 0.04 %; p = 0.04). CT performed by a high-volume surgeon had much lower remnant uptakes (0.06 vs. 0.22 %; p = 0.04). Remnant uptake followed a stepwise decrease with involvement of a high-volume surgeon for part or all of the surgical management (p = 0.11). Multiple regression analysis found CT (p = 0.02) and surgeon volume (p = 0.04) to significantly influence uptake after controlling for other factors. Conclusions. Single-stage TT provides a better resection based on smaller thyroid remnant uptakes than CT for patients with thyroid cancer. If a staged operation for cancer is necessary, surgeon volume may affect the completeness of resection.

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