Nodal Capsular Invasion as a Risk Factor for Subsequent Early Recurrence after First Recurrence of Well Differentiated Thyroid Cancer | ||
| SECI Oncology Journal | ||
| Volume 13, Issue 1, January 2025, Pages 58-67 | ||
| Abstract | ||
| Introduction: Although thyroid cancer is the most prevalent endocrine malignancy, however it’s responsible for less than 0.5% of cancer related death. Large number of researches had examined different factors that may affect recurrence such as age, sex, thyroid tumor size, histological types, and lymphatic invasion, which had all been used as an indicator for poor outcome. In our study, Lymph node (L.N.) capsular invasion by tumor had been assessed as a factor affecting recurrence in well differentiated thyroid cancer patients (WDTC) after first recurrence. Aim: To assess the effect of neck L.N. capsular invasion in well differentiated thyroid cancer on subsequent recurrences Patients and methods: This retrospective cohort study was carried on 40 patients with neck recurrence of WDTC who were referred to National cancer institute (NCI) between June 2014 and June 2015. Data was collected regarding initial disease stage, type of recurrence, time till recurrence, investigation done, and previous treatment. Adequate management of those patients was done (further investigation and surgical treatment), histopathology are obtained and documented Results: Of the 40 patients included in the study, 35 patients showed nodal affection in their first recurrence, with 15 of them showed L.N. capsular invasion. Of these 15 patients, 7 patients showed subsequent second recurrence (46.7%), 3 of them with nodal affection and 4 with operative bed only recurrence. L.N capsular invasion was found in 3 patients of the 7 with second recurrence. Of the 25 patients with no L.N. capsular invasion in their first recurrence only 8 showed second recurrence (32%). Conclusion: Among those patients with multiple recurrence of WDTC, males that aged over 40 years with aggressive primary tumor and advanced stage, and those with L.N. capsular invasion, have a significant risk of multiple recurrence and possibly poor outcome. L.N. capsular invasion showed that it may be an important factor for further recurrences which may put those patients among higher risk group that need more aggressive management and more precise follow up. | ||
| Keywords | ||
| Well differentiated thyroid cancer (WDTC); recurrence; neck nodes; capsular invasion | ||
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