Thyroidectomy for thyroid cancer in the elderly: A meta-analysis

Joseph, Kyle R.; Edirimanne, Senarath; Eslick, Guy D.

doi:10.1016/j.ejso.2018.07.055

Cited by 18 publications

(16 citation statements)

References 45 publications

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“…It is also used to treat benign disease [e.g., multinodular goiter, GD and (Hashimoto’s) thyroiditis], in cases where the thyroid gland cannot be (partially) preserved. TT also cause several surgical complications, including postthyroidectomy hypocalcemia, hemorrhage and recurrent laryngeal nerve palsy, which are avoidable in most cases, but not all ( 9 , 10 ). Among these, hypocalcemia is the most common but critical complication and requires urgent treatment because of the risks for tetany, bronchospasm and cardiac arrythmias ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

A Meta-Analysis of Risk Factors for Transient and Permanent Hypocalcemia After Total Thyroidectomy

et al. 2021

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BackgroundAs hypocalcemia is the most common complication of total thyroidectomy, identifying its risk factors should guide prevention and management. The purpose of this study was to determine the risk factors for postthyroidectomy hypocalcemia.MethodsWe searched PubMed, Web of Science and EMBASE through January 31, 2019, and assessed study quality using the Newcastle–Ottawa Scale.ResultsFifty studies with 22,940 patients met the inclusion criteria, of which 24.92% (5716/22,940) had transient hypocalcemia and 1.96% (232/11,808) had permanent hypocalcemia. Significant (P < 0.05) predictors of transient hypocalcemia were: younger age, female, parathyroid autotransplantation (PA), inadvertent parathyroid excision (IPE), Graves’ disease (GD), thyroid cancer, central lymph node dissection, preoperative severe Vitamin D deficiency, preoperative Vitamin D deficiency and a lower postoperative 24 h parathyroid hormone (PTH) level. Preoperative magnesium, preoperative PTH and Hashimoto’s thyroiditis were not significant predictors of transient hypocalcemia. IPE, GD, and thyroid cancer were associated with an increased rate of permanent hypocalcemia, but gender and PA did not predict permanent hypocalcemia.ConclusionImportant risk factors for transient and permanent hypocalcemia were identified. However, given the limited sample size and heterogeneity of this meta-analysis, further studies are required to confirm our preliminary findings.

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Section: Discussionmentioning

confidence: 99%

A Meta-Analysis of Risk Factors for Transient and Permanent Hypocalcemia After Total Thyroidectomy

et al. 2021

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“…et al (37); they found advanced age was related to higher rates of extended length of hospital stay and surgery-related readmissions. In terms of the efficiency and safety, Joseph et al (38) also reported an increased complication recurrence rate and reduced disease-free survival in a metaanalysis performed to investigate survival prognosis and complications in elderly patients with PTC, who underwent thyroidectomy. However, the rates for complications and tumor prognosis did not differ significantly between the age subgroups in the present study.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Radiofrequency Ablation Versus Surgical Resection for the Treatment of T1bN0M0 Papillary Thyroid Carcinoma in Different Age Groups

Zhao

et al. 2021

Front. Endocrinol.

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PurposeWe aimed to compare the efficacy and safety of radiofrequency ablation (RFA) to that of surgical resection (SR) in patients with T1bN0M0 papillary thyroid carcinoma (PTC) in different age groups.MethodsTotally, 204 patients with an isolated, solitary, intrathyroidal T1bN0M0 PTC, who underwent either RFA (n=94) or SR (n=110) between April 2014 and December 2019, were retrospectively enrolled and were divided into two subgroups according to age (<45 years, ≧45 years). Patients with pathologically aggressive or advanced lesions were excluded from the study. Tumor progression and procedural complications were the primary and secondary endpoints, respectively. Tumor recurrence in situ, newly discovered tumors, lymph node involvement, or distant metastases indicated tumor progression. Complications included pain, fever, voice change, choking, numbness in the limbs, and cardiac events. Incidence rates of all endpoint events were compared between different age subgroups.ResultsThere were no significant differences in age, sex, and tumor size between the treatment groups. While the RFA group incurred less cost and experienced significantly shorter operative duration than the SR group, no significant differences were observed in incidences of both tumor progression and complications. Further, subgroup analysis of patients <45 years versus those ≧45 years showed no significant differences in the incidence of tumor progression and complications within or between different treatment groups. Older patients in the SR group incurred higher hospital costs than younger counterparts, but this difference was not observed in the RFA group.ConclusionsOur results indicated that RFA had a similar prognosis as that of SR but was associated with lower overall cost in both young (<45 years) and middle-aged patients (≧45 years) with T1bN0M0 PTC. Therefore, RFA may be an effective and safe alternative to surgery for the treatment of patients with T1bN0M0 PTC.

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“…All elderly patients who developed hematoma were hypertensive and had a history of cardiac stents requiring anti-coagulation medication. Recently, a meta-analysis of thyroidectomy for thyroid cancer (TC) in elderly patients reported increased mortality rates [Hazard Ratio 1.95] and risk of complications [Odds Ratio 1.82] following thyroidectomy compared to younger patients [13]. In another study, Echanique et al [1] reported that the incidence of RLN injury increased in patients with age >65 while hypoparathyroidism decreased with age>65 but <85 years.…”

Section: Discussionmentioning

confidence: 99%

Comparative outcomes of thyroid surgery in elderly patients: A retrospective cohort study

Ataş¹,

Imga²

2020

Journal of Surgery and Medicine

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All procedures in this study involving human participants were performed in accordance with the 1964 Helsinki Declaration and its later amendments. Etik Kurul Onayı: Çalışma protokolü Ankara Numune Eğitim ve Araştırma Hastanesi Etik Kurulu tarafından onaylandı (Tarih: 07/02/2019, No: E-19-2474). İnsan katılımcıların katıldığı çalışmalardaki tüm prosedürler, 1964 Helsinki Deklarasyonu ve daha sonra yapılan değişiklikler uyarınca gerçekleştirilmiştir.

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Thyroidectomy for thyroid cancer in the elderly: A meta-analysis

Cited by 18 publications

References 45 publications

A Meta-Analysis of Risk Factors for Transient and Permanent Hypocalcemia After Total Thyroidectomy

A Meta-Analysis of Risk Factors for Transient and Permanent Hypocalcemia After Total Thyroidectomy

Ultrasound-Guided Radiofrequency Ablation Versus Surgical Resection for the Treatment of T1bN0M0 Papillary Thyroid Carcinoma in Different Age Groups

Comparative outcomes of thyroid surgery in elderly patients: A retrospective cohort study

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