Short-term Follow-up US Leads to Higher False-positive Results Without Detection of Structural Recurrences in PTMC. Issue 1 (January 2016)

• Record Type: Journal Article
• Authors: Yoon, Jung Hyun; Lee, Hye Sun; Kim, Eun-Kyung; Youk, Ji Hyun; Kim, Hyun Gi; Moon, Hee Jung; Kwak, Jin Young
• Other Names: Wall. Patrick section editor.
• Is Part Of: Medicine. Volume 95:Issue 1(2016)
• Publication Date: 2016-01
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000002435
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: To investigate the value of the annual follow-up neck ultrasonography (US) for postoperative surveillance in patients with papillary thyroid microcarcinoma (PTMC). This retrospective study has been approved by our institutional review board (IRB) with waiver for informed consent. A total of 375 patients diagnosed as PTMCs, who underwent total thyroidectomy with radioiodine remnant ablation were included, to identify the recurrence rate and the false-positive rate of annual ultrasound. The number, interval, and the results of follow-up US or fine needle aspiration were obtained from electronic medical records. Four (1.1%, 4/375) recurrences were found 3 years after the initial treatment, and only 1 patient (0.3%, 1/375) had a metastatic lymph node larger than 8 mm in the shortest diameter on US found 7.6 years after initial treatment with biochemical abnormalities. Cumulative risk of having at least 1 false-positive exam was 8.3% by the 8th US, and 8.1% by the 8–9 year follow-up. Cox multivariate regression showed shorter interval of follow-up US and presence of lymph node metastasis at initial surgery are independent predictors affecting the cumulative false-positive results (hazard ratio [HR], 0.60; 95% confidence interval [CI]: 0.49–0.73; P < 0.001 and HR, 2.19; 95% CI: 1.01–4.75; P = 0.048, respectively). Short-term follow-up US can result in higher cumulative false-positive results without detection of meaningful recurrences in patients with PTMCs who do not have biochemical abnormalities. Abstract : Supplemental Digital Content is available in the text