Short-term follow-up US leads to higher false-positive results without detection of structural recurrences in PTMC

Jung Hyun Yoon, Hye Sun Lee, Eun Kyung Kim, Ji Hyun Youk, Hyun Gi Kim, Hee Jung Moon, Jin Young Kwak

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

To investigate the value of the annual follow-up neck ultrasonography (US) for postoperative surveillance in patients with papillary thyroid microcarcinoma (PTMC). This retrospective study has been approved by our institutional review board (IRB) with waiver for informed consent. A total of 375 patients diagnosed as PTMCs, who underwent total thyroidectomy with radioiodine remnant ablation were included, to identify the recurrence rate and the false-positive rate of annual ultrasound. The number, interval, and the results of follow-up US or fine needle aspiration were obtained from electronic medical records. Four (1.1%, 4/375) recurrences were found 3 years after the initial treatment, and only 1 patient (0.3%, 1/375) had a metastatic lymph node larger than 8mm in the shortest diameter on US found 7.6 years after initial treatment with biochemical abnormalities. Cumulative risk of having at least 1 false-positive exam was 8.3% by the 8th US, and 8.1% by the 8-9 year follow-up. Cox multivariate regression showed shorter interval of follow-up US and presence of lymph node metastasis at initial surgery are independent predictors affecting the cumulative falsepositive results (hazard ratio [HR], 0.60; 95% confidence interval [CI]: 0.49-0.73; P<0.001 and HR, 2.19; 95% CI: 1.01-4.75; P=0.048, respectively). Short-term follow-up US can result in higher cumulative falsepositive results without detection of meaningful recurrences in patients with PTMCs who do not have biochemical abnormalities.

Original languageEnglish
Article numbere2435
JournalMedicine (United States)
Volume95
Issue number1
DOIs
Publication statusPublished - 2016

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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