caa a22 4500 445336706 CHVBK 20180317142758.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1245/s10434-010-1470-9 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1470-9 Central Compartment Reoperation for Recurrent/Persistent Differentiated Thyroid Cancer: Patterns of Recurrence, Morbidity, and Prediction of Postoperative Hypocalcemia [Elektronische Daten] [Jong-Lyel Roh, Jin-Man Kim, Chan Park] Background: Incidence rates of hypoparathyroidism and vocal cord paralysis are high following central compartment reoperation, but few prospective studies have assessed morbidities and factors predictive of hypocalcemia after reoperation. We investigated recurrence patterns, morbidity, and factors predictive of postoperative hypocalcemia in patients undergoing central compartment reoperation for recurrent/persistent differentiated thyroid cancer (DTC). Methods: We prospectively evaluated 45 consecutive patients with recurrent/persistent DTC. Thyroid remnants or recurrent cancers were removed in 16 patients, the unilateral or bilateral central compartment was cleared in all patients, and the lateral compartment on the diseased side was comprehensively removed from 24 patients. Recurrence patterns were assessed histopathologically, morbidities were monitored, and serum concentrations of calcium and intact parathyroid hormone (iPTH) were measured in all patients. Results: Eleven patients (24.4%) had tumor invasion into the recurrent laryngeal nerve and/or the tracheoesophagus. Central nodal involvement occurred frequently (86.7%), and the ipsilateral jugular nodes of the lateral compartment were frequently involved. Temporary and permanent vocal cord paralysis developed in 10 (22.2%) and 8 (17.8%) patients, respectively, due primarily to intentional nerve resection following tumor invasion. Of 41 patients without preoperative hypoparathyroidism, 21 (46.3%) had temporary and 2 (4.9%) had permanent hypocalcemia. Multivariate analysis showed that bilateral central compartment dissection and low iPTH levels (<12.0pg/ml) were independent predictors of postoperative hypocalcemia. Conclusions: Most patients with recurrent/persistent DTC harbor lesions in the central compartment. Central compartment reoperation may lead to high rates of morbidity, including hypoparathyroidism, which can be predicted by surgical extent and low serum iPTH levels. Society of Surgical Oncology, 2010 Roh Jong-Lyel Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea aut Kim Jin-Man Departments of Pathology, Chungnam National University College of Medicine, Daejeon, Republic of Korea aut Park Chan Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, Republic of Korea aut Annals of Surgical Oncology Springer-Verlag 18/5(2011-05-01), 1312-1318 1068-9265 18:5<1312 2011 18 10434 https://doi.org/10.1245/s10434-010-1470-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1470-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Roh Jong-Lyel Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Kim Jin-Man Departments of Pathology, Chungnam National University College of Medicine, Daejeon, Republic of Korea aut NATIONALLICENCE 700 1- Park Chan Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, Republic of Korea aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/5(2011-05-01), 1312-1318 1068-9265 18:5<1312 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer