Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer

Maria A. Kouvaraki, Suzanne E. Shapiro, Bruno D. Fornage, Beth S. Edeiken-Monro, Steven I. Sherman, Rena Vassilopoulou-Sellin, Jeffrey E. Lee, Douglas B. Evans, Keith S. Heller, Allan Siperstein, Ian D Hay, Irving B. Rosen, Scott Wilhelm

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Abstract

Background. Cervical recurrence occurs in up to 30% of patients with differentiated thyroid carcinoma. We retrospectively compared preoperative transcutaneous ultrasonography and physical examination (PE) results in the detection of local-regional metastases (lymph node and soft tissue) in patients with thyroid cancer. Methods. Data were collected retrospectively from the medical records of patients with thyroid carcinoma who underwent preoperative ultrasonography. Patients were divided into 3 groups: group 1, those undergoing primary thyroid/neck surgery; group 2, those undergoing reoperation for persistent disease; and group 3, those undergoing reoperation for recurrent thyroid carcinoma. For each group, we recorded the frequencies with which ultrasonography detected disease in a neck compartment (central or lateral) that was normal on PE. Results. Two hundred twelve patients underwent operation for primary, persistent, or recurrent papillary (n = 130), medullary (n = 61), or follicular/Hürthle cell (n = 21) carcinoma. Ultrasonography detected additional sites of metastatic disease not appreciated on PE in 21 (20%) of 107 group 1 patients, 9 (32%) of 28 group 2 patients, and 52 (68%) of 77 group 3 patients. The surgical procedure performed was altered by the information obtained from preoperative ultrasonography in 82 (39%) of the 212 patients. Of the 107 group 1 patients, cervical recurrence has been detected in only 6 (6%) at a median follow-up of 36 months, in spite of 67 (63%) having tumors larger than 2 cm or lymph node metastases. Conclusions. Preoperative high-quality ultrasonography detected lymph node or soft-tissue metastases in neck compartments believed to be uninvolved by PE in 39% of patients. Ultrasound findings altered the operative procedure in these patients, facilitating complete resection of disease and potentially minimizing local-regional recurrence.

Original languageEnglish (US)
Pages (from-to)946-955
Number of pages10
JournalSurgery
Volume134
Issue number6
DOIs
StatePublished - Dec 2003

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Thyroid Neoplasms
Ultrasonography
Physical Examination
Neck
Lymph Nodes
Neoplasm Metastasis
Reoperation
Recurrence
Operative Surgical Procedures
Medical Records
Thyroid Gland
Carcinoma

ASJC Scopus subject areas

  • Surgery

Cite this

Kouvaraki, M. A., Shapiro, S. E., Fornage, B. D., Edeiken-Monro, B. S., Sherman, S. I., Vassilopoulou-Sellin, R., ... Wilhelm, S. (2003). Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer. Surgery, 134(6), 946-955. https://doi.org/10.1016/S0039-6060(03)00424-0

Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer. / Kouvaraki, Maria A.; Shapiro, Suzanne E.; Fornage, Bruno D.; Edeiken-Monro, Beth S.; Sherman, Steven I.; Vassilopoulou-Sellin, Rena; Lee, Jeffrey E.; Evans, Douglas B.; Heller, Keith S.; Siperstein, Allan; Hay, Ian D; Rosen, Irving B.; Wilhelm, Scott.

In: Surgery, Vol. 134, No. 6, 12.2003, p. 946-955.

Research output: Contribution to journalArticle

Kouvaraki, MA, Shapiro, SE, Fornage, BD, Edeiken-Monro, BS, Sherman, SI, Vassilopoulou-Sellin, R, Lee, JE, Evans, DB, Heller, KS, Siperstein, A, Hay, ID, Rosen, IB & Wilhelm, S 2003, 'Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer', Surgery, vol. 134, no. 6, pp. 946-955. https://doi.org/10.1016/S0039-6060(03)00424-0
Kouvaraki MA, Shapiro SE, Fornage BD, Edeiken-Monro BS, Sherman SI, Vassilopoulou-Sellin R et al. Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer. Surgery. 2003 Dec;134(6):946-955. https://doi.org/10.1016/S0039-6060(03)00424-0
Kouvaraki, Maria A. ; Shapiro, Suzanne E. ; Fornage, Bruno D. ; Edeiken-Monro, Beth S. ; Sherman, Steven I. ; Vassilopoulou-Sellin, Rena ; Lee, Jeffrey E. ; Evans, Douglas B. ; Heller, Keith S. ; Siperstein, Allan ; Hay, Ian D ; Rosen, Irving B. ; Wilhelm, Scott. / Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer. In: Surgery. 2003 ; Vol. 134, No. 6. pp. 946-955.
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abstract = "Background. Cervical recurrence occurs in up to 30{\%} of patients with differentiated thyroid carcinoma. We retrospectively compared preoperative transcutaneous ultrasonography and physical examination (PE) results in the detection of local-regional metastases (lymph node and soft tissue) in patients with thyroid cancer. Methods. Data were collected retrospectively from the medical records of patients with thyroid carcinoma who underwent preoperative ultrasonography. Patients were divided into 3 groups: group 1, those undergoing primary thyroid/neck surgery; group 2, those undergoing reoperation for persistent disease; and group 3, those undergoing reoperation for recurrent thyroid carcinoma. For each group, we recorded the frequencies with which ultrasonography detected disease in a neck compartment (central or lateral) that was normal on PE. Results. Two hundred twelve patients underwent operation for primary, persistent, or recurrent papillary (n = 130), medullary (n = 61), or follicular/H{\"u}rthle cell (n = 21) carcinoma. Ultrasonography detected additional sites of metastatic disease not appreciated on PE in 21 (20{\%}) of 107 group 1 patients, 9 (32{\%}) of 28 group 2 patients, and 52 (68{\%}) of 77 group 3 patients. The surgical procedure performed was altered by the information obtained from preoperative ultrasonography in 82 (39{\%}) of the 212 patients. Of the 107 group 1 patients, cervical recurrence has been detected in only 6 (6{\%}) at a median follow-up of 36 months, in spite of 67 (63{\%}) having tumors larger than 2 cm or lymph node metastases. Conclusions. Preoperative high-quality ultrasonography detected lymph node or soft-tissue metastases in neck compartments believed to be uninvolved by PE in 39{\%} of patients. Ultrasound findings altered the operative procedure in these patients, facilitating complete resection of disease and potentially minimizing local-regional recurrence.",
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T1 - Role of preoperative ultrasonography in the surgical management of patients with thyroid cancer

AU - Kouvaraki, Maria A.

AU - Shapiro, Suzanne E.

AU - Fornage, Bruno D.

AU - Edeiken-Monro, Beth S.

AU - Sherman, Steven I.

AU - Vassilopoulou-Sellin, Rena

AU - Lee, Jeffrey E.

AU - Evans, Douglas B.

AU - Heller, Keith S.

AU - Siperstein, Allan

AU - Hay, Ian D

AU - Rosen, Irving B.

AU - Wilhelm, Scott

PY - 2003/12

Y1 - 2003/12

N2 - Background. Cervical recurrence occurs in up to 30% of patients with differentiated thyroid carcinoma. We retrospectively compared preoperative transcutaneous ultrasonography and physical examination (PE) results in the detection of local-regional metastases (lymph node and soft tissue) in patients with thyroid cancer. Methods. Data were collected retrospectively from the medical records of patients with thyroid carcinoma who underwent preoperative ultrasonography. Patients were divided into 3 groups: group 1, those undergoing primary thyroid/neck surgery; group 2, those undergoing reoperation for persistent disease; and group 3, those undergoing reoperation for recurrent thyroid carcinoma. For each group, we recorded the frequencies with which ultrasonography detected disease in a neck compartment (central or lateral) that was normal on PE. Results. Two hundred twelve patients underwent operation for primary, persistent, or recurrent papillary (n = 130), medullary (n = 61), or follicular/Hürthle cell (n = 21) carcinoma. Ultrasonography detected additional sites of metastatic disease not appreciated on PE in 21 (20%) of 107 group 1 patients, 9 (32%) of 28 group 2 patients, and 52 (68%) of 77 group 3 patients. The surgical procedure performed was altered by the information obtained from preoperative ultrasonography in 82 (39%) of the 212 patients. Of the 107 group 1 patients, cervical recurrence has been detected in only 6 (6%) at a median follow-up of 36 months, in spite of 67 (63%) having tumors larger than 2 cm or lymph node metastases. Conclusions. Preoperative high-quality ultrasonography detected lymph node or soft-tissue metastases in neck compartments believed to be uninvolved by PE in 39% of patients. Ultrasound findings altered the operative procedure in these patients, facilitating complete resection of disease and potentially minimizing local-regional recurrence.

AB - Background. Cervical recurrence occurs in up to 30% of patients with differentiated thyroid carcinoma. We retrospectively compared preoperative transcutaneous ultrasonography and physical examination (PE) results in the detection of local-regional metastases (lymph node and soft tissue) in patients with thyroid cancer. Methods. Data were collected retrospectively from the medical records of patients with thyroid carcinoma who underwent preoperative ultrasonography. Patients were divided into 3 groups: group 1, those undergoing primary thyroid/neck surgery; group 2, those undergoing reoperation for persistent disease; and group 3, those undergoing reoperation for recurrent thyroid carcinoma. For each group, we recorded the frequencies with which ultrasonography detected disease in a neck compartment (central or lateral) that was normal on PE. Results. Two hundred twelve patients underwent operation for primary, persistent, or recurrent papillary (n = 130), medullary (n = 61), or follicular/Hürthle cell (n = 21) carcinoma. Ultrasonography detected additional sites of metastatic disease not appreciated on PE in 21 (20%) of 107 group 1 patients, 9 (32%) of 28 group 2 patients, and 52 (68%) of 77 group 3 patients. The surgical procedure performed was altered by the information obtained from preoperative ultrasonography in 82 (39%) of the 212 patients. Of the 107 group 1 patients, cervical recurrence has been detected in only 6 (6%) at a median follow-up of 36 months, in spite of 67 (63%) having tumors larger than 2 cm or lymph node metastases. Conclusions. Preoperative high-quality ultrasonography detected lymph node or soft-tissue metastases in neck compartments believed to be uninvolved by PE in 39% of patients. Ultrasound findings altered the operative procedure in these patients, facilitating complete resection of disease and potentially minimizing local-regional recurrence.

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