Central lymph node dissection and permanent hypoparathyroidism after total thyroidectomy for papillary thyroid cancer : population-based study
(2021) In British Journal of Surgery 108(6). p.684-690- Abstract
Background: Papillary thyroid cancer is treated with total/near-total thyroidectomy (TT) with or without central lymph node dissection (CLND), depending on risk factors and tumour size. Balancing the risk of disease recurrence and surgical morbidity remains a challenge. A population-based nationwide study was undertaken to evaluate the risk of permanent hypoparathyroidism associated with CLND. Method: Data on patients with stage pT1–3 papillary thyroid cancer, who underwent TT with or without CLND between 1 July 2004 and 30 June 2014 were retrieved from the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery. Drug use was ascertained by cross-linking with the Swedish Prescribed Drug Register. Permanent... (More)
Background: Papillary thyroid cancer is treated with total/near-total thyroidectomy (TT) with or without central lymph node dissection (CLND), depending on risk factors and tumour size. Balancing the risk of disease recurrence and surgical morbidity remains a challenge. A population-based nationwide study was undertaken to evaluate the risk of permanent hypoparathyroidism associated with CLND. Method: Data on patients with stage pT1–3 papillary thyroid cancer, who underwent TT with or without CLND between 1 July 2004 and 30 June 2014 were retrieved from the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery. Drug use was ascertained by cross-linking with the Swedish Prescribed Drug Register. Permanent hypoparathyroidism was defined as treatment with active D vitamin or oral calcium drugs for more than 6 months after surgery. Data were analysed separately for all patients and those who underwent TT + CLND. Univariable and multivariable logistic regression analyses were done, yielding odds ratios (ORs) with 95 per cent confidence intervals. Results: A total of 722 patients were included in the study. Permanent hypoparathyroidism was more common in the TT + CLND group than the TT group: 30 of 265 patients (6·6 per cent) versus six of 457 (2·3 per cent) (P = 0·011). In multivariable logistic regression analysis, CLND was a risk factor for permanent hypoparathyroidism (OR 3·74, 95 per cent c.i. 1·46 to 9·59, based on use of combined therapy 6 months after surgery). In patients who had TT + CLND, node negativity was associated with a risk of permanent hypoparathyroidism (OR 3·08, 1·31 to 7·25). Conclusion: CLND is an independent risk factor for permanent hypoparathyroidism. Node negativity is associated with a higher risk of permanent hypoparathyroidism.
(Less)
- author
- Salem, F. A. LU ; Bergenfelz, A. LU ; Nordenström, E. LU and Almquist, M. LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- British Journal of Surgery
- volume
- 108
- issue
- 6
- pages
- 684 - 690
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85090980244
- pmid:32936933
- ISSN
- 0007-1323
- DOI
- 10.1002/bjs.12028
- language
- English
- LU publication?
- yes
- id
- e80de27f-8dd8-4d44-b119-8af6852b60a5
- date added to LUP
- 2020-10-26 09:49:17
- date last changed
- 2024-04-17 16:53:19
@article{e80de27f-8dd8-4d44-b119-8af6852b60a5,
abstract = {{<p>Background: Papillary thyroid cancer is treated with total/near-total thyroidectomy (TT) with or without central lymph node dissection (CLND), depending on risk factors and tumour size. Balancing the risk of disease recurrence and surgical morbidity remains a challenge. A population-based nationwide study was undertaken to evaluate the risk of permanent hypoparathyroidism associated with CLND. Method: Data on patients with stage pT1–3 papillary thyroid cancer, who underwent TT with or without CLND between 1 July 2004 and 30 June 2014 were retrieved from the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery. Drug use was ascertained by cross-linking with the Swedish Prescribed Drug Register. Permanent hypoparathyroidism was defined as treatment with active D vitamin or oral calcium drugs for more than 6 months after surgery. Data were analysed separately for all patients and those who underwent TT + CLND. Univariable and multivariable logistic regression analyses were done, yielding odds ratios (ORs) with 95 per cent confidence intervals. Results: A total of 722 patients were included in the study. Permanent hypoparathyroidism was more common in the TT + CLND group than the TT group: 30 of 265 patients (6·6 per cent) versus six of 457 (2·3 per cent) (P = 0·011). In multivariable logistic regression analysis, CLND was a risk factor for permanent hypoparathyroidism (OR 3·74, 95 per cent c.i. 1·46 to 9·59, based on use of combined therapy 6 months after surgery). In patients who had TT + CLND, node negativity was associated with a risk of permanent hypoparathyroidism (OR 3·08, 1·31 to 7·25). Conclusion: CLND is an independent risk factor for permanent hypoparathyroidism. Node negativity is associated with a higher risk of permanent hypoparathyroidism.</p>}},
author = {{Salem, F. A. and Bergenfelz, A. and Nordenström, E. and Almquist, M.}},
issn = {{0007-1323}},
language = {{eng}},
number = {{6}},
pages = {{684--690}},
publisher = {{Oxford University Press}},
series = {{British Journal of Surgery}},
title = {{Central lymph node dissection and permanent hypoparathyroidism after total thyroidectomy for papillary thyroid cancer : population-based study}},
url = {{http://dx.doi.org/10.1002/bjs.12028}},
doi = {{10.1002/bjs.12028}},
volume = {{108}},
year = {{2021}},
}