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Total Thyroidectomy vs Thyroid Lobectomy for Localized Papillary Thyroid Cancer in Children: A Propensity-Matched Survival Analysis
- Source :
- Journal of the American College of Surgeons. 233(1)
- Publication Year :
- 2021
-
Abstract
- Current guidelines recommend total thyroidectomy (TT) and radioablation for most papillary thyroid cancer (PTC) in children. These guidelines have been criticized as aggressive, especially for early-stage PTC, as it likely does not influence patient survival and results in life-long thyroid hormone replacement. We sought to study whether the extent of thyroidectomy (TT vs thyroid lobectomy [TL]) influences overall and disease-specific survival in children with localized PTC.The National Cancer Database and the Surveillance, Epidemiology, and End Results registries were queried. Patients 18 years or younger with low-risk PTC between 2004 and 2016 were included. Using a 1:1 propensity score matching, patients who underwent TT were matched for age, sex, race, year of diagnosis, and tumor size with a similar cohort of patients who underwent TL. Primary end points were overall survival and disease-specific survival.There were 3,500 patients identified as surgically treated for PTC, of which 1,325 patients met inclusion criteria for matching. Three hundred and twenty-six patients were matched. One hundred and sixty-three patients had TT; 140 were female and mean age was 16 years (interquartile range [IQR] 13 to 17 years). One hundred and sixty-three patients had TL; 140 were female and mean age was 16 years (IQR 14 to 17 years). Median follow-up was 5.0 years (IQR 2.8 to 8 years) and 8.3 years (IQR 3.6 to 14.4 years) in the National Cancer Database and Surveillance, Epidemiology, and End Results cohorts, respectively. There was no statistically significant difference in overall survival or disease-specific survival in patients with PTC4 cm, regardless of whether patients underwent TT or TL (p = 0.32 for National Cancer Database registry and p = 0.67 for Surveillance, Epidemiology, and End Results registry).This study suggests that the extent of thyroidectomy does not influence survival for pediatric patients with early-stage PTC and that TL might be adequate in this patient population.
- Subjects :
- Male
medicine.medical_specialty
endocrine system diseases
Adolescent
medicine.medical_treatment
Thyroid Lobectomy
Papillary thyroid cancer
03 medical and health sciences
0302 clinical medicine
Interquartile range
Internal medicine
medicine
Surveillance, Epidemiology, and End Results
Humans
Registries
Thyroid Neoplasms
Child
Propensity Score
Survival analysis
business.industry
Thyroid
Thyroidectomy
medicine.disease
Survival Analysis
medicine.anatomical_structure
Thyroid Cancer, Papillary
030220 oncology & carcinogenesis
Cohort
030211 gastroenterology & hepatology
Surgery
Female
business
Subjects
Details
- ISSN :
- 18791190
- Volume :
- 233
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Surgeons
- Accession number :
- edsair.doi.dedup.....05c886ea6fe750da48976404a0031152