Current surgical treatment of intermediate risk differentiated thyroid cancer: a systematic review

Guo, Michael; Wiseman, Jacob J; Wiseman, Sam M.

doi:10.1080/14737140.2021.1850280

Cited by 4 publications

(1 citation statement)

References 68 publications

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“…Although we recognize that a previous neck dissection might lead to a higher rate of postsurgical athyroglobulinemia, potentially increasing the sensitivity of thyroglobulin for long-term follow-up (26)(27)(28), we believe this finding should not alter the interpretation of our results. Mounting evidence shows that low-and intermediaterisk papillary carcinoma submitted to thyroidectomy without neck dissection can be safely monitored with thyroglobulin (1,(29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

The role of neck ultrasound in the follow-up of low- and intermediate- risk papillary thyroid cancer

Lopes¹,

Ferreira²,

Fernandes³

et al. 2022

Archives of Endocrinology and Metabolism

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Objective:The optimal time for a neck ultrasound (US) in the follow-up of papillary thyroid cancer (PTC) after the first year is undetermined. We aimed to verify the utility of routine neck US in the surveillance of patients diagnosed with low-and intermediate-risk PTC with no evidence of disease at the one-year assessment. Materials and methods: We conducted a retrospective longitudinal study of patients with low-and intermediate-risk PTC with normal neck US, unstimulated serum thyroglobulin (Tg) < 1 ng/mL and negative anti-Tg antibodies at the one-year follow-up. Patients were divided into group 1 [undetectable Tg (<0.20 ng/mL)] and group 2 [detectable Tg but < 1 ng/mL]. The negative predictive value (NPV) of the one-year unstimulated Tg at the five-year and last follow-up visits was calculated. Results: We included n = 88 patients in group 1 and n = 8 patients in group 2. No patient from group 1 presented suspicious US findings at the five-year evaluation [NPV: 100.0% (95% confidence interval (CI): 95.5%-100.0%)], and at the last visit, only one patient had developed a lymph node classified as suspicious [NPV: 98.8% (95% CI: 93.2%-100.0%); mean follow-up: 6.7 years]. In group 2, two patients' USs presented suspicious findings at the five-year evaluation [NPV: 75.0% (95% CI: 34.9%-96.8%)]. At the last visit, only one patient persisted with suspicious findings in the US [NPV: 87.5% (95% CI: 47.4%-99.7%); mean follow-up: 6.5 years]. Conclusion: Low-and intermediaterisk PTC with an excellent response to treatment at the one-year assessment can be safely monitored with regular unstimulated Tg assessments. Conclusions should not be drawn for Tg levels between 0.20-0.99 ng/mL.

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Section: Discussionmentioning

confidence: 99%

The role of neck ultrasound in the follow-up of low- and intermediate- risk papillary thyroid cancer

Lopes¹,

Ferreira²,

Fernandes³

et al. 2022

Archives of Endocrinology and Metabolism

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Comparative effectiveness totally endoscopic thyroidectomy via completely submental tri-hole approach and transoral endoscopic thyroidectomy without insufflation

Wang,

Li,

Fan

et al. 2024

Langenbecks Arch Surg

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Objective This study aims to evaluate the therapeutic effectiveness of totally endoscopic thyroidectomy via the completely submental tri-hole approach and transoral endoscopic thyroidectomy without insufflation. Methods A total of 60 patients with thyroid tumors who were admitted to Panyu College Affiliated Hospital from August 2022 to August 2023 were collected in this study. The patients were divided into two groups, the transoral endoscopic thyroidectomy group (20 cases) and the totally endoscopic thyroidectomy via the completely submental tri-hole approach group (40 cases). Then, we evaluated the difference of surgical data, operative details, postoperative complications, duration of postoperative swelling, cosmetic satisfaction, discomfort during eating, and pain scores between two groups. Results There were no significant differences between two groups in terms of operation time, intraoperative blood loss, postoperative drainage, extubation time, length of hospital stay, autotransplantation of parathyroid glands, or postoperative swelling. And neither group experienced voice hoarseness, postoperative bleeding, or lymphatic leakage. The incidence of hypocalcemia did not differ significantly between two groups, although the transoral endoscopic thyroidectomy group had a significantly higher incidence of chin numbness ( p <0.01). Futhermore, there was no obvious differences in neck pain scores or cosmetic satisfaction scores at 3 days, 7 days, 2 weeks, and 1 month postoperatively. However, the discomfort during eating score was markedly lower in the totally endoscopic thyroidectomy group compared to the transoral endoscopic thyroidectomy group ( P < 0.05). Conclusion Totally endoscopic thyroidectomy via the completely submental tri-hole approach offers advantages in reducing postoperative discomfort during eating compared to transoral endoscopic thyroidectomy, indicating promising prospects for clinical application.

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Controversies in the Management of Intermediate-Risk Differentiated Thyroid Cancer

Toro-Tobon,

Brito

2024

Endocrine Practice

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Current surgical treatment of intermediate risk differentiated thyroid cancer: a systematic review

Cited by 4 publications

References 68 publications

The role of neck ultrasound in the follow-up of low- and intermediate- risk papillary thyroid cancer

The role of neck ultrasound in the follow-up of low- and intermediate- risk papillary thyroid cancer

Comparative effectiveness totally endoscopic thyroidectomy via completely submental tri-hole approach and transoral endoscopic thyroidectomy without insufflation

Controversies in the Management of Intermediate-Risk Differentiated Thyroid Cancer

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