{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T10:44:05Z","timestamp":1756464245148},"reference-count":30,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2007,10,22]],"date-time":"2007-10-22T00:00:00Z","timestamp":1193011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2007,10,22]],"date-time":"2007-10-22T00:00:00Z","timestamp":1193011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2007,10,22]],"date-time":"2007-10-22T00:00:00Z","timestamp":1193011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2007,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to assess the efficacy of treatment of patients with papillary thyroid carcinoma (PTC) and lymph node metastases at the time of diagnosis and its influence on the course of the disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>It is a retrospective review of all 51 patients with PTC and histologically proven lymph node metastases treated with I\u2010131 ablation in our center between January 1990 and January 2003. Patients were considered disease\u2010free if during follow\u2010up thyroglobulin levels were undetectable and scintigraphy with 370\u00a0MBq <jats:sup>131<\/jats:sup>I was negative during thyroid\u2010stimulating hormone stimulation. Staging of patients was in accordance with the 5th edition of the TNM system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After a median follow\u2010up of 84\u00a0months, 33 (65%) patients were never free of detectable disease; and 3 of these patients had died of the PTC. In total, 22 patients still showed persistent activity in the neck outside the thyroid bed, which was suspect to be cervical lymph node metastasis on postablation scintigraphy; it was not related to the initial clinical presentation (lymph node metastasis or a thyroid nodule without suspicion of metastatic disease) or to the extent of surgery. Altogether, 34 patients required additional treatment. Patients presenting with clinically overt lymph node metastasis showed a significantly (<jats:italic>p<\/jats:italic> = 0.022) lower rate of becoming disease\u2010free than those in whom microscopic lymph node involvement was unexpectedly found upon pathologic examination. There was no significant association of the eventual outcome with the extent of surgical treatment, TNM staging, or age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with lymph node metastasis are considerably less likely to become disease\u2010free. If the initial treatment does not result in a disease\u2010free status, chances are low that additional treatment will succeed in achieving it.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-007-9257-2","type":"journal-article","created":{"date-parts":[[2007,10,21]],"date-time":"2007-10-21T16:29:32Z","timestamp":1192984172000},"page":"2309-2314","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Persistent Disease in Patients with Papillary Thyroid Carcinoma and Lymph Node Metastases After Surgery and Iodine\u2010131 Ablation"],"prefix":"10.1002","volume":"31","author":[{"given":"Frederik A.","family":"Verburg","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine University Medical Center Utrecht Utrecht The Netherlands"},{"name":"Department of Nuclear Medicine University Hospital W\u00fcrzburg Josef Schneiderstrasse 2, Bau D5 97080 W\u00fcrzburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bart","family":"de Keizer","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marnix G. 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