Abstract
In 1994, 21 Belarus children presenting papillary thyroid cancer (PTC) diagnosed after the Chernobyl disaster, and already submitted to subtotal surgery, underwent thyroid re-operation and post-operative radioiodine (131 I) therapy. All were re-evaluated after a 15-year follow-up, to evaluate the results of partial versus total thyroidectomy. Nineteen out of 21 children (mean age 9.2 years) had previously undergone a lobectomy. All cases underwent re-operation in 1994. Histology revealed a PTC in the residual lobe in three cases, three had lymph node metastases. After surgery, 20 patients underwent 131 I therapy. The post-131 I whole body scan was negative in seven cases, showed neck node metastases in five, lung metastases in three, multiple associated metastases in six. The follow-up was performed with rhTSH-stimulated serum thyroglobulin (Tg) evaluation and ultrasonography. Twenty patients showed TgI therapy showed a thyroid remnant and a Tg of 32 ng/ml. Chi-square analysis showed significantly higher prevalences of residual cancer in the neck or lung, lymph node metastases, and re-operations (before completion) in patients who had undergone lobectomy than in those who had undergone completion thyroidectomy and 131 I therapy. The surgical complications after lobectomy were similar to those after completion thyroidectomy. A less-than-total thyroidectomy should not be indicated in patients with radiation-induced PTC, due to the high risk of residual cancer in the thyroid left in situ. The results of this study favor total thyroidectomy as the initial treatment for thyroid cancer in children exposed to fallout radiation.
| Original language | English |
|---|---|
| Pages (from-to) | 432-436 |
| Number of pages | 5 |
| Journal | Endocrine |
| Volume | 40 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Dec 2011 |
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Keywords
- Chernobyl
- Childhood
- Complications
- Radiation
- Thyroid cancer
- Thyroidectomy
ASJC Scopus subject areas
- Endocrinology
- Endocrinology, Diabetes and Metabolism
Cite this
Lobectomy versus total thyroidectomy in children with post-Chernobyl thyroid cancer : A 15 year follow-up. / Antonelli, Alessandro; Fallahi, Poupak; Grosso, Mariano; Boni, Giuseppe; Minuto, Michele N.; Miccoli, Paolo.
In: Endocrine, Vol. 40, No. 3, 12.2011, p. 432-436.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Lobectomy versus total thyroidectomy in children with post-Chernobyl thyroid cancer
T2 - A 15 year follow-up
AU - Antonelli, Alessandro
AU - Fallahi, Poupak
AU - Grosso, Mariano
AU - Boni, Giuseppe
AU - Minuto, Michele N.
AU - Miccoli, Paolo
PY - 2011/12
Y1 - 2011/12
N2 - In 1994, 21 Belarus children presenting papillary thyroid cancer (PTC) diagnosed after the Chernobyl disaster, and already submitted to subtotal surgery, underwent thyroid re-operation and post-operative radioiodine (131 I) therapy. All were re-evaluated after a 15-year follow-up, to evaluate the results of partial versus total thyroidectomy. Nineteen out of 21 children (mean age 9.2 years) had previously undergone a lobectomy. All cases underwent re-operation in 1994. Histology revealed a PTC in the residual lobe in three cases, three had lymph node metastases. After surgery, 20 patients underwent 131 I therapy. The post-131 I whole body scan was negative in seven cases, showed neck node metastases in five, lung metastases in three, multiple associated metastases in six. The follow-up was performed with rhTSH-stimulated serum thyroglobulin (Tg) evaluation and ultrasonography. Twenty patients showed TgI therapy showed a thyroid remnant and a Tg of 32 ng/ml. Chi-square analysis showed significantly higher prevalences of residual cancer in the neck or lung, lymph node metastases, and re-operations (before completion) in patients who had undergone lobectomy than in those who had undergone completion thyroidectomy and 131 I therapy. The surgical complications after lobectomy were similar to those after completion thyroidectomy. A less-than-total thyroidectomy should not be indicated in patients with radiation-induced PTC, due to the high risk of residual cancer in the thyroid left in situ. The results of this study favor total thyroidectomy as the initial treatment for thyroid cancer in children exposed to fallout radiation.
AB - In 1994, 21 Belarus children presenting papillary thyroid cancer (PTC) diagnosed after the Chernobyl disaster, and already submitted to subtotal surgery, underwent thyroid re-operation and post-operative radioiodine (131 I) therapy. All were re-evaluated after a 15-year follow-up, to evaluate the results of partial versus total thyroidectomy. Nineteen out of 21 children (mean age 9.2 years) had previously undergone a lobectomy. All cases underwent re-operation in 1994. Histology revealed a PTC in the residual lobe in three cases, three had lymph node metastases. After surgery, 20 patients underwent 131 I therapy. The post-131 I whole body scan was negative in seven cases, showed neck node metastases in five, lung metastases in three, multiple associated metastases in six. The follow-up was performed with rhTSH-stimulated serum thyroglobulin (Tg) evaluation and ultrasonography. Twenty patients showed TgI therapy showed a thyroid remnant and a Tg of 32 ng/ml. Chi-square analysis showed significantly higher prevalences of residual cancer in the neck or lung, lymph node metastases, and re-operations (before completion) in patients who had undergone lobectomy than in those who had undergone completion thyroidectomy and 131 I therapy. The surgical complications after lobectomy were similar to those after completion thyroidectomy. A less-than-total thyroidectomy should not be indicated in patients with radiation-induced PTC, due to the high risk of residual cancer in the thyroid left in situ. The results of this study favor total thyroidectomy as the initial treatment for thyroid cancer in children exposed to fallout radiation.
KW - Chernobyl
KW - Childhood
KW - Complications
KW - Radiation
KW - Thyroid cancer
KW - Thyroidectomy
UR - http://www.scopus.com/inward/record.url?scp=84858758902&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84858758902&partnerID=8YFLogxK
U2 - 10.1007/s12020-011-9500-3
DO - 10.1007/s12020-011-9500-3
M3 - Article
C2 - 21698517
AN - SCOPUS:84858758902
VL - 40
SP - 432
EP - 436
JO - Endocrine
JF - Endocrine
SN - 1355-008X
IS - 3
ER -