Isthmusectomy in selected patients with well-differentiated thyroid carcinoma.

Authors :: Park H
Harries V
McGill MR
Ganly I
Shah JP
Source :: Head & neck [Head Neck] 2020 Jan; Vol. 42 (1), pp. 43-49. Date of Electronic Publication: 2019 Oct 07.
Publication Year :: 2020
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.<br />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.<br />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%.<br />Conclusions: Isthmusectomy alone is an acceptable procedure in selected patients with low- and intermediate-risk WDTC limited to the isthmus.<br /> (© 2019 Wiley Periodicals, Inc.)