Abstract
ObjectivesThe purpose of this study is to evaluate the risk of stroke (hemorrhagic or ischemic) after neck dissection in thyroid cancer patients in Korea using national cohort data.MethodsUsing the national cohort study from the Korean Health Insurance Review and Assessment Service, patients with neck dissection for thyroid cancer (1,041) and control participants (4,164) were selected and matched 1:4 (age, gender, income, and region of residence). The Chi-square test, Fischer’s exact test, and the Cox-proportional hazard model were used. The Cox-proportional analysis used a crude model and an adjusted model for age, gender, income, region of residence, hypertension, diabetes, dyslipidemia.ResultsNone of the participants had suffered hemorrhagic stroke in the neck dissection group, while 0.3% (13/4,164) of participants had suffered hemorrhagic stroke in the control group (P = 0.085). In total, 0.8% (8/1,041) of participants had suffered an ischemic stroke in the neck dissection group, and 0.7% (31/4,133) of participants had suffered an ischemic stroke in the control group (P = 0.936). The adjusted hazard ratio for ischemic stroke after neck dissection was 1.06 (95% confidence interval [CI] = 0.49–2.31, P = 0.884).ConclusionThe risk of hemorrhagic or ischemic stroke was not higher in thyroid cancer patients who underwent neck dissection than that in the matched control group.
Highlights
Neck dissection is a common treatment option for lymph node metastasis in patients with head and neck cancer
0.8% (8/1,041) of participants had suffered an ischemic stroke in the neck dissection group, and 0.7% (31/4,133) of participants had suffered an ischemic stroke in the control group (P = 0.936)
The purpose of this study is to evaluate the risk of stroke after neck dissection in thyroid cancer patients
Summary
Neck dissection is a common treatment option for lymph node metastasis in patients with head and neck cancer. Rechtweg et al described their experience with neck dissection with simultaneous carotid endarterectomy [2]. In their discussion, Yoo et al stated that 3.2% of patients among 441 patients with 560 neck dissections suffered a stroke [2]. Neck dissection could result in hemodynamic instability, blood loss, and the exposure and handling of the vascular structure of the neck, which could increase the risk of stroke [4]. Thompson et al reported a low incidence of stroke after neck dissection (0.2%) and concluded that perioperative screening or intervention is not needed [4]. Chang et al reported that neck dissection does not increase the incidence of stoke in oral cavity cancer patients [6]
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