1. Optimizing surgical outcomes in papillary thyroid carcinoma with Hashimoto’s Thyroiditis: a retrospective comparative study of unilateral and total thyroidectomy
- Author
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Xiaoyong Wen, Shiwei Zhou, Wu Li, Hui Li, Xiaohua Song, Yu Mao, Zeyu Li, Guangji Chen, Xiaowei Peng, and Peng Wu
- Subjects
Papillary thyroid carcinoma ,Hashimoto’s thyroiditis ,Unilateral thyroidectomy ,Total thyroidectomy ,Preoperative thyroid peroxidase antibody ,Fatigue ,Medicine ,Science - Abstract
Abstract The management of papillary thyroid carcinoma (PTC) concurrent with Hashimoto’s thyroiditis (HT) lacks standardized guidelines, especially concerning surgical strategies. This study aimed to compare unilateral thyroidectomy (UT) with total thyroidectomy (TT) in PTC-HT patients to optimize clinical management and improve postoperative outcomes. This retrospective study included PTC-HT patients undergoing thyroid surgery at a tertiary academic medical institution from January 2018 to August 2023. The patients were grouped according to the quartiles of preoperative thyroid peroxidase antibody (TPOAB) levels at the last follow-up. Additionally, patients were divided into UT and TT groups, with propensity score matching (PSM) to ensure comparability. Patients were also stratified by TPOAB levels (L: 100–400, M: 400–1000, H: >1000). Patient-reported outcomes (PROMs), including quality of life and fatigue, were compared between UT and TT groups within each TPOAB subgroup (ΔPROMs = UT-TT). 246 patients were included. Those with higher TPOAB levels at the last follow-up reported increased physical fatigue scores. After PSM, there were no significant demographic differences between UT and TT groups. During a median follow-up of 16 months for UT and 20 months for TT, no recurrence or metastasis occurred. Compared to the UT group, the TT group exhibited lower TPOAB levels at the last follow-up (65.7 ± 78 vs. 374.6 ± 331.9, p
- Published
- 2024
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