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Preoperative computed tomography changes surgical management for clinically low-risk well-differentiated thyroid cancer

Annals of Surgical Oncology Oct 13, 2019

Bongers PJ, Verzijl R, Dzingala M, et al. - Given a limited role of CT of the neck in the current guidelines for differentiated thyroid cancer (DTC), researchers investigated if the surgical management for a portion of patients changes with adding CT to the workup of clinically low-risk DTC size 4 cm or smaller due to detection of clinically significant lymph node metastases not located by ultrasound of the neck. In this prospective study, CT was performed before surgery on all the patients who had fine-needle aspiration cytopathology results suspicious for malignancy or malignant tumor (Bethesda category 5 or 6, respectively). Clinically low-risk DTC patients who had a tumor diameter of 4 cm or less and who had no evidence for local invasion or suspicious lymph nodes seen on ultrasound were selected for this work. Changes in the surgical management of 25 (22.5%) of 111 patients with clinically low-risk DTC were made in correlation with the CT findings of clinically significant nodal disease not detected by ultrasound. This indicates the favorable impact of adding CT to the preoperative staging for the detection of nodal metastasis in certain practice settings.
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