Surgical treatment of recurrent differentiated thyroid carcinoma.

OBJECTIVE: To describe our experience of treating recurrent thyroid carcinoma. DESIGN: Retrospective study of casenotes. SETTING: Teaching hospital, Mexico. SUBJECTS: 20 patients who developed recurrences of 273 who presented with well-differentiated thyroid carcinoma between 1991 and 1999. MAIN OUTCOME MEASURES: Presentation, management, morbidity, and mortality. RESULTS: There were 18 men and 2 women, median age 51 years (range 28-75). 13 were treated initially by total thyroidectomy and 7 with less than total resection. 16 were given ablative doses of 311I. The median time between initial resection and recurrence was 3 years (range 1-6). The sites of recurrence were cervical lymph nodes (n = 12), thyroid bed (n = 3), or both (n = 5). During a median of 3 years 10 patients were free of disease and 2 had died. CONCLUSIONS: Well-differentiated thyroid cancer usually recurs in the cervical lymph nodes. Further resection offers a high cure rate.