ETA2022 Oral Presentations Oral Session 3: Advanced Thyroid Cancer (5 abstracts)
Thyroid cancer relapse as a challenge to a surgeon: The efficacy of radioguided occult lesion localization (roll) technique
Agnieszka Czarniecka 1 , Grzegorz Wozniak 2 , Marcin Zeman 3 , Michal Kalemba 4 , Zbigniew Wygoda 5 , Ewa Chmielik 6 , Ewa Stobiecka 6 , Alexander J. Cortez 7 , Jolanta Krajewska 8 & Daria Handkiewicz-Junak 8
1M. Sklodowska-Curie National Research Institute of Oncology Gliwice Branch,, The Oncologic and Reconstructive Surgery Clinic, Gliwice, Poland; 2Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 1. The Oncologic and Reconstructive Surgery Clinic, Gliwice, Poland; 3Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch,, 1. The Oncologic and Reconstructive Surgery Clinic, Gliwice, Poland; 4Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch,, 2. Department of Nuclear Medicine and Endocrine Oncology,, Gliwice, Poland; 5Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 2. Department of Nuclear Medicine and Endocrine Oncology, Gliwice, Poland; 6Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 3. Tumor Pathology Department, Gliwice, Poland; 7Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Department of Biostatistics and Bioinformatics, Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska–curie National Research Institute of Oncology, Gliwice, Poland; 8Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 2. Department of Nuclear Medicine and Endocrine Oncology, Gliwice, Poland
Introduction: Reoperation due to recurrent or persistent thyroid cancer (TC) poses a real challenge to a surgeon who must properly estimate the benefit risk-ratio. Radioguided occult lesion localization (ROLL) technique may facilitate the localization and sufficient and safe removal of nonpalpable TC relapse.
Aim: To analyze the efficacy of the ROLL technique in reoperation of TC relapse.
Material and methods: A retrospective study of 254 TC patients (186 papillary TC, 24 follicular TC, 34 medullary TC, 10 poorly differentiated TC) reoperated on from 2002 and 2018 was performed. There were 180 (70.9 %) women and 74 (29.1%) men, mean age 47.2 years (median 50.7 years) with 7.82 years of the mean follow-up (median 5.81 years). All the relapses were preoperatively marked by ultrasound-guided administration of technetium Tc-99m albumin colloid (0.1 ml).
Results: The main localization of relapse was the thyroid bed – central neck compartment (178; 70.1%). Recurrence diameters ranged from 2 to 17 mm. In 71% of cases intralesional administration of the radiotracer was used and in 29% the radiotracer was applied in the lesion area. There was no difference in the efficacy of the relapse removal between these groups (P=0.926). In 55 patients (21.7%) multifocal recurrence was found and removed. No differences in the efficacy of relapse removal were observed depending on the histological type and multifocal nature of recurrence (P=0.08). In 19 patients (7.5%) relapse was not found in ROLL procedure (necessity of reoperation). No differences were found between the recurrent laryngeal nerve paresis after the primary and secondary operation (P=0.7) as in the case of postoperative hypoparathyroidism (P=0.4). More than 1 reoperation was performed in 42 patients. In this subgroup, 1 death (2%) was observed, disease progression was noted in 12 patients (29%) and complete remission was found in 28 (67%). In the whole group, complete remission was observed in 198 patients (78%) during the follow-up.
Conclusions: The ROLL technique in TC is a safe and effective procedure that facilitates intraoperative localization and removal of TC recurrence.
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Endocrine Abstracts
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