Completion thyroidectomy for thyroid carcinoma

Rao, Renuka; Fakih, Abdul R.; Mehta, Ashok; Agarwal, Rajeev; Raghavan, Ashok; Shrikhande, Sumati S.

doi:10.1002/hed.2890090506

Cited by 22 publications

(6 citation statements)

References 4 publications

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“…Papillary thyroid cancer is known to be multifocal in about 30–80% (Rao et al ., 1987; Auguste & Attie, 1990; Pacini et al ., 2001), thus initial total thyroidectomy remains an effective and safe treatment method to reduce the surgical risk of the patients and facilitate to perform radioactive iodine therapy. Follicular thyroid cancer tends to be less multifocal than papillary thyroid cancer does but they are much more aggressive and, if they are widely invasive or extrathyroidal disease is found, completion thyroidectomy should also be performed.…”

Section: Discussionmentioning

confidence: 99%

Completion thyroidectomy in patients with thyroid cancer who initially underwent unilateral operation

Kim

Kim²,

Koh³

et al. 2004

Clinical Endocrinology

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Section: Discussionmentioning

confidence: 99%

Completion thyroidectomy in patients with thyroid cancer who initially underwent unilateral operation

Kim

Kim²,

Koh³

et al. 2004

Clinical Endocrinology

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“…The concerns about increased morbidity with more than a thyroid lobectomy are not necessarily justified. Irl experienced hands, total thyroidectomy, and more importantly secondary thyroid operations, can be performed safely with little morbidity to the patient [9,13,24,25,27,34]. Calabro and coworkers,[24] in a recent review of completion thyroidecto" mies, reported an incidence of transient hypocalcemia of 129~ and transient RLN palsy of 1.5%.…”

Section: Discussionmentioning

confidence: 99%

The incidence of bilateral well‐differentiated thyroid cancer found at completion thyroidectomy

et al. 1992

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The purpose of this study was to evaluate the surgical outcome of completion thyroidectomy in patients with presumed unilateral well-differentiated thyroid cancer (WDTC). The medical records of all patients having had unilateral thyroid lobectomy for WDTC, who subsequently underwent completion thyroidectomy, were reviewed. From 1980 to 1991, 60 patients with WDTC underwent completion thyroidectomy. Forty-seven patients had presumed unilateral WDTC, with no evidence of residual disease prior to their completion thyroidectomy. Twenty-five (53%) of these patients were found to have residual neoplastic disease in the neck. In 20 (43%) of 47 patients, a focus of cancer was found in the remaining thyroid lobe and in 5 additional patients no cancer was found in the contralateral lobe, however, unsuspected nodal disease was found. The remaining 13 of the 60 patients presented with either regional recurrence (n = 12) or distant metastases (n = 1) at the time of their completion thyroidectomy. All (92%) but 1 of these 13 patients had cancer in the remaining thyroid lobe. Multifocal disease in the primary lobe was associated with bilateral thyroid cancer (p less than 0.01). Complications were infrequent; transient hypocalcemia occurred in 5 (8%) patients, permanent hypoparathyroidism occurred in 1 (1.7%) patient, and transient recurrent laryngeal nerve palsy occurred in 3 (5%) patients. Residual WDTC was found in 37 (62%) of 60 patients undergoing completion thyroidectomy. Multifocal disease in the primary resected lobe was associated with a high incidence of contralateral thyroid cancer. Completion thyroidectomy is a safe procedure and may prevent the development of regional recurrence by eliminating an unsuspected focus of cancer.

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“…The complication rates of surgery, laryngeal nerve injury, and hypoparathyroidism are the main reason to choose lobectomy in DTC patients with primary tumor size ≤1 cm [13, 14]. However, in the hands of an experienced thyroid surgeon, the complication rate of total thyroidectomy is as low as 2% while the incidence of recurrent laryngeal nerve palsy is increased in cases of reoperation for recurrences in the contralateral lobe [15–17].…”

Section: Discussionmentioning

confidence: 99%

Thyroidectomy as Treatment of Choice for Differentiated Thyroid Cancer

Giuffrida¹,

Giuffrida²,

Puliafito³

et al. 2019

International Journal of Surgical Oncology

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Background Despite a large amount of data, the optimal surgical management of differentiated thyroid cancer remains controversial. Current guidelines recommend total thyroidectomy if primary thyroid cancer is >4 cm, while for tumors that are between 1 and 4 cm in size, either a bilateral or a unilateral thyroidectomy may be appropriate as surgical treatment. In general, total thyroidectomy would seem to be preferable because subtotal resection can be correlated with a higher risk of local recurrences and cervical lymph node metastases; on the other hand, total thyroidectomy is associated with more complications. Methods This is a retrospective study conducted on 359 patients with differentiated thyroid cancer, subjected to total thyroidectomy. Our aim was to correlate clinical and pathological features (extrathyroid tumor growth, bilaterality, nodal and distant metastasis) with patient (gender and age) and tumor (size and histotype) characteristics. Moreover, we recorded postoperative complications, including hypoparathyroidism and laryngeal nerve damage. Results In our study, we found a high occurrence of pathological features indicating cancer aggressiveness (bilaterality, nodal metastases, and extrathyroid invasion). On the other hand, total thyroidectomy was associated with relatively low postsurgical complication rates. Conclusions Our data support the view that total thyroidectomy remains the first choice for the routine treatment of differentiated thyroid cancer.

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Completion thyroidectomy for thyroid carcinoma

Cited by 22 publications

References 4 publications

Completion thyroidectomy in patients with thyroid cancer who initially underwent unilateral operation

Completion thyroidectomy in patients with thyroid cancer who initially underwent unilateral operation

The incidence of bilateral well‐differentiated thyroid cancer found at completion thyroidectomy

Thyroidectomy as Treatment of Choice for Differentiated Thyroid Cancer

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