Back to Search
Start Over
Should multifocality be an indication for completion thyroidectomy in papillary thyroid carcinoma?
- Source :
- Surgery. 167:10-17
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Background Multifocality in papillary thyroid carcinoma is common. The aim of this study is to determine whether patients with multifocal disease, treated with lobectomy alone, have an increased risk of contralateral lobe papillary thyroid carcinoma, regional recurrence, and poorer survival. Methods After institutional review board approval, papillary thyroid carcinoma patients managed from 1986 to 2015 with lobectomy alone were identified from an institutional database. Papillary thyroid carcinoma patients with pT3 to T4 classification, nodal disease, or distant metastases were excluded. After excluding 40 patients who underwent an immediate completion thyroidectomy, 849 were included in the analysis; 619 (72.9%) had unifocal disease and 230 (27.1%) had multifocal disease. Contralateral lobe papillary thyroid carcinoma-free probability, regional recurrence-free probability, disease-specific survival, and overall survival were calculated using the Kaplan-Meier method. Results With a median follow-up of 58 months, unifocal disease and multifocal disease patients had similar rates of contralateral lobe papillary thyroid carcinoma, regional recurrence, and overall survival (10-year contralateral lobe papillary thyroid carcinoma-free probability 98.6% vs 97.8%; regional recurrence-free probability 99.5% vs 99.4%; overall survival 91.6% vs 93.1%, respectively). There were no disease-related deaths. Conclusion Select multifocal disease patients, managed with lobectomy alone, have rates of contralateral lobe papillary thyroid carcinoma, regional recurrence, and overall survival comparable to unifocal disease patients. Multifocal disease should not be an indication for completion thyroidectomy.
- Subjects :
- Male
medicine.medical_specialty
Thyroid Gland
Aftercare
Kaplan-Meier Estimate
030230 surgery
Disease-Free Survival
Thyroid carcinoma
03 medical and health sciences
0302 clinical medicine
Risk Factors
medicine
Humans
Thyroid Neoplasms
Thyroid cancer
Retrospective Studies
Completion thyroidectomy
business.industry
Patient Selection
Thyroid
Retrospective cohort study
Middle Aged
Institutional review board
medicine.disease
Increased risk
medicine.anatomical_structure
Thyroid Cancer, Papillary
Lymphatic Metastasis
030220 oncology & carcinogenesis
Unifocal Disease
Thyroidectomy
Female
Surgery
Radiology
Neoplasm Recurrence, Local
business
Subjects
Details
- ISSN :
- 00396060
- Volume :
- 167
- Database :
- OpenAIRE
- Journal :
- Surgery
- Accession number :
- edsair.doi.dedup.....247cb4b73549dec5d74ffcb536c99a26