1. Isthmusectomy in selected patients with well-differentiated thyroid carcinoma
- Author
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Jatin P. Shah, Marlena McGill, Ian Ganly, Victoria Harries, and Hakyoung Park
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Thyroid ,030230 surgery ,Prognosis ,Carcinoma, Papillary ,Article ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Internal medicine ,Risk stratification ,medicine ,Thyroidectomy ,Humans ,Thyroid Neoplasms ,Neoplasm Recurrence, Local ,business ,Well Differentiated Thyroid Carcinoma ,Lymph node ,Retrospective Studies - Abstract
Background Isthmusectomy in the treatment of well-differentiated thyroid carcinoma (WDTC) is controversial. In this study, we analyze the outcomes of WDTC managed by isthmusectomy alone. Methods Forty-three patients treated with isthmusectomy alone were identified from an institutional database of 6259 surgically treated patients with WDTC. Patient and tumor characteristics were analyzed. Disease-specific survival (DSS) and recurrence-free survival (RFS) were calculated using the Kaplan-Meier method. Results The pT classification was T1 for 41 and T2 for two patients. All were clinical N0, but 10 pts were pN1a. Using the American Thyroid Association risk stratification system, 9 patients were low-risk and 22 were intermediate-risk. One patient developed local recurrence, and two developed regional lymph node metastases; the 5- and 10-year DSS was 100.0%. The 5- and 10-year RFS was 93.1%. Conclusions Isthmusectomy alone is an acceptable procedure in selected patients with low- and intermediate-risk WDTC limited to the isthmus.
- Published
- 2019