Postoperative ultrasonography surveillance in patients with follicular thyroid carcinoma: a multicenter study.

OBJECTIVE: This study aimed to evaluate the locoregional recurrence rate of follicular thyroid carcinoma (FTC) and to assess the appropriate frequency of postoperative ultrasonography (US) surveillance for detecting tumor recurrence.

METHODS: The review boards of the seven participating institutions approved this study. From 2000 to 2011, 186 patients underwent at postoperative US at least once; US was performed by experienced radiologists at each institution. Based on the US and histopathological results, locoregional tumor recurrence was assessed.

RESULTS: The T stages of the 186 patients were T1a (8.1%), T1b (21.5%), T2 (39.8%), T3 (30.6%), T4a (0%), and T4b (0%). The N stages were unknown (24.2%), N0 (71.5%), N1a (3.2%), and N1b (1.1%), and the M stages unknown (29.6%), M0 (66.1%), and M1 (4.3%). Tumors recurred in only 6 (3.2%) patients during the follow-up period over 5 years. Among them, no patients showed the initial suspicion of recurrences on routine follow-up US. The session number and interval of postoperative US differed significantly between patients with recurrence and those without recurrence. The mean interval of postoperative follow-up US at the first detection time of tumor recurrence was 37.5 ± 18.5 months (range 9-62 months). Significantly more FTCs were at an advanced N and M stage in the recurrence group than in the non-recurrence group (p < 0.05).

CONCLUSIONS: Routine postoperative US surveillance may be unnecessary for detecting tumor recurrence after thyroid surgery in FTC patients.