Intraoperative ultrasonography is useful in surgical management of neck metastases in differentiated thyroid cancers

Endocrine. 2015 Feb;48(1):248-53. doi: 10.1007/s12020-014-0287-x. Epub 2014 May 27.

Abstract

Differentiated thyroid carcinomas are the most common malignancies of endocrine organs. Metastases to cervical lymph nodes occur in 20-50% of cases. Recurrence and survival rates are closely related to the type of surgery performed. High-resolution ultrasonography (USG) is a sensitive imaging method used to detect occult lymph node metastases in patients with thyroid cancer. We evaluated how intraoperative USG affected surgical success. This was a retrospective study comparing two groups of patients with thyroid carcinoma who underwent cervical lymph node dissection. A total of 101 patients (33 males and 68 females) were included. Group 1 included 53 patients who underwent surgery with intraoperative USG guidance. Group 2 included 48 patients who underwent surgery without the use of USG. All patients were followed up (mean 23 months; range 5-44 months) with thyroglobulin measurements and USG evaluations. Group 1 (intraoperative USG) had a residual/recurrent tumor rate of 1.9% (1/53 patients). Group 2 had a residual/recurrent tumor rate of 12.5% (6/48 patients). A statistically significant difference appeared between the residual/recurrent tumor rates in Groups 1 and 2 (p<0.05). In addition to its classical use in diagnosis and follow-up, intraoperative use of high-resolution USG can improve surgical success and may decrease the number of residual/recurrent tumors encountered during follow-up.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / diagnostic imaging*
  • Head and Neck Neoplasms / secondary
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Intraoperative Period
  • Lymph Nodes / diagnostic imaging
  • Lymphatic Metastasis / diagnostic imaging
  • Male
  • Middle Aged
  • Neck Dissection / methods
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Retrospective Studies
  • Thyroid Neoplasms / pathology*
  • Thyroidectomy
  • Ultrasonography
  • Young Adult