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

Abstract

When diagnosed as thyroid cancer after unilateral surgery, the only predictive factor for the presence of additional contralateral cancer was multifocality of cancer in the ipsilateral lobe. We suggest that completion thyroidectomy is mandatory if multifocal cancers are found in the resected lobe, even though the cancers are very small and limited within the thyroid.

Oncologic Results of Completion Thyroidectomy and Secondary Prophylactic Lymph Node Dissection in the Management of Differentiated Thyroid Cancer

“…These results are in line with previous studies, thus confirming that a total thyroidectomy should be performed to treat DTC when the tumour exceeds 1 cm or in the case of multifocal disease [7][8][9][10][11].…”

Multicentricidade no carcinoma diferenciado da tireóide

“…Such fact happened to one of our patients, but we were unable to follow him up. Although some authors 9 indicate that the thyroidectomy completion should be carried out between three and six months of the first surgical intervention in order to prevent complications, this is not what we advocate, in agreement with Kim et al 16 , who indicate the second intervention as early as possible, as a means to reduce the chance of hematogenic and lymphatic spread of the residual tumor to the contralateral lobe of these patients. The cases studied were operated in the first 30 days of postoperative from the first intervention, and such fact also occurred in other series studied 4,6,10,12 .…”

“…De Jong et al Showed an incidence of 43% of contralateral lobe involvement in 100 patients; Kim et al 16 showed an incidence of 31% in 81 patients and Pacini et al 17 , showed an incidence of 44% in 80 patients. These data match the ones in our series, which was of 23.8% (five in 21 patients).…”

Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Taskforce

“…Some patients with malignancy may require completion thyroidectomy to provide complete resection of multicentric disease (114), and to allow radioiodine therapy. Most (115,116) but not all (114) studies of papillary cancer have observed a higher rate of cancer in the opposite lobe when multifocal (Ն 2 foci), as opposed to unifocal, disease is present in the ipsilateral lobe. The surgical risks of two-stage thyroidectomy (lobectomy followed by completion thyroidectomy) are similar to those of a near-total or total thyroidectomy (117,118).…”