Total thyroidectomy versus thyroid lobectomy for papillary thyroid cancer: Comparative analysis after propensity score matching: A multicenter study

Kuba, Sayaka; Yamanouchi, Kaoru; Hayashida, Naomi; Maeda, Shuichi; Adachi, Toshiyuki; Sakimura, Chika; Kawakami, Fusako; Yano, Hiroshi; Matsumoto, Megumi; Otsubo, Ryota; Sato, Shuntaro; Fujioka, Hikaru; Kuroki, Tamotsu; Nagayasu, Takeshi; Eguchi, Susumu

doi:10.1016/j.ijsu.2016.09.083

Cited by 67 publications

(22 citation statements)

References 20 publications

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“…The recurrence rates at 5, 10, and 20 years were non-statistically different (1.9%, 4.3%, and 6.5% vs. 2.3%, 4.1%, and 5.9%, hemi- vs. total thyroidectomy, respectively), and no differences were seen for OS rates as well. Kuba et al [37] reported similar findings on 33 pairs of macroscopic PTC patients. The results of the above studies are in accordance with those reported by us.…”

Section: Discussionmentioning

confidence: 56%

Long-Term Outcome after Hemithyroidectomy for Papillary Thyroid Cancer: A Comparative Study and Review of the Literature

Geron

Benbassat

Shteinshneider

et al. 2018

Cancers

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Background: The extent of surgery for differentiated thyroid cancer (DTC) remains a controversial issue. Since a less aggressive approach is becoming more predominant, we aim here to study the short- and long-term outcomes of DTC patients after hemithyroidectomy. Methods: From a total of 1252 consecutive papillary thyroid cancer (PTC) patients, 109 treated with hemithyroidectomy and 50 with total thyroidectomy but no I131 were included. Persistent or recurrent disease was defined based on histopathology, imaging studies, and thyroglobulin levels. Results: Our hemithyroidectomy cohort included females (84.4%), microcarcinomas (81.9%), TNM stage I (95.4%), and a low American Thyroid Association (ATA) recurrence risk (94.5%). At one-year post-treatment, 3.7% had persistent disease (all female, median age 55 years, tumor size 7.5 mm). Recurrent disease was detected in 7.5% of those with excellent response at 1-year. With a follow-up of 8.6 years (1–48), all 109 patients were disease free at last visit, including the 11 patients (10.1%) who received additional treatment. Also, when comparing the hemi- and total thyroidectomy groups no significant differences were found in the rate of persistent and recurrent disease, overall mortality, and disease status at last visit. Conclusions: For properly selected low-risk PTC patients, hemithyroidectomy is a safe treatment option with a favorable long-term outcome.

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Section: Discussionmentioning

confidence: 56%

Long-Term Outcome after Hemithyroidectomy for Papillary Thyroid Cancer: A Comparative Study and Review of the Literature

Geron

Benbassat

Shteinshneider

et al. 2018

Cancers

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“…On the other hand, Lee et al reported a 0.9% recurrence rate in the contralateral lobe, but 87% of the tumors in this study were micropapillary cancers [61]. Many retrospective studies, with various inclusion criteria, have reported global recurrence rates ranging from 4.2-7.1% after lobectomy for low-risk cancers [19,[62][63][64][65]. Contralateral thyroid nodules generally appear within five years of initial therapy [66].…”

Section: Oncologic Considerations: Recurrence In the Contralateral Lomentioning

confidence: 60%

Thyroid Lobectomy for Low to Intermediate Risk Differentiated Thyroid Cancer

Hartl

Guerlain

Breuskin

et al. 2020

Cancers

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Many recent publications and guidelines have promoted a “more is less” approach in terms of treatment for low to intermediate risk differentiated thyroid cancer (DTC), which comprise the vast majority of thyroid cancers: less extensive surgery, less radioactive iodine, less or no thyroid hormone suppression, and less frequent or stringent follow-up. Following this approach, thyroid lobectomy has been proposed as a means of decreasing short- and long-term postoperative morbidity while maintaining an excellent prognosis for tumors meeting specific macroscopic and microscopic criteria. This article will examine the pros and cons of thyroid lobectomy for low to intermediate risk cancers and discuss, in detail, criteria for patient selection and oncological outcomes.

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“…There was no statistically significant difference of local recurrences in TL compared to TT, and distant metastases recurrence rates were higher in TT. Of note, only five studies [ 17 , 18 , 29 , 36 , 45 ] mentioned ultrasound as a routine preoperative assessment but only in patients evaluated since 2005 [ 43 ], while all studies also included patients who were treated before 2005. Thus, malignancies in the contralateral remnant lobe and small cervical lymph node metastases might have been missed, resulting in suboptimal treatment in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies do not report an association between tumor multicentricity and prognosis, thus the clinical significance of occult carcinoma is questionable [ 39 , 53 , 55 , 56 ]. Of the studies included in this meta-analysis that mentioned multicentricity, none showed an association between multicentricity and prognosis [ 17 , 18 , 29 , 37 , 44 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of the Extent of Surgery on the Long-Term Outcomes of Patients with Low-Risk Differentiated Non-Medullary Thyroid Cancer: A Systematic Meta-Analysis

Bojoga

Koot

Bonenkamp

et al. 2020

JCM

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Recently, the management of patients with low-risk differentiated non-medullary thyroid cancer (DTC), including papillary and follicular thyroid carcinoma subtypes, has been critically appraised, questioning whether these patients might be overtreated without a clear clinical benefit. The American Thyroid Association (ATA) guideline suggests that thyroid lobectomy (TL) could be a safe alternative for total thyroidectomy (TT) in patients with DTC up to 4 cm limited to the thyroid, without metastases. We conducted a meta-analysis to assess the clinical outcomes in patients with low-risk DTC based on the extent of surgery. The risk ratio (RR) of recurrence rate, overall survival (OS), disease-free survival (DFS) and disease specific survival (DSS) were estimated. In total 16 studies with 175,430 patients met the inclusion criteria. Overall, low recurrence rates were observed for both TL and TT groups (7 vs. 7%, RR 1.10, 95% CI 0.61–1.96, I2 = 72%), and no statistically significant differences for OS (TL 94.1 vs. TT 94.4%, RR 0.99, CI 0.99–1.00, I2 = 53%), DFS (TL 87 vs. TT 91%, RR 0.96, CI 0.89–1.03, I2 = 85%), and DSS (TL 97.2 vs. TT 95.4%, RR 1.01, CI 1.00–1.01, I2 = 74%). The high degree of heterogeneity of the studies is a notable limitation. Conservative management and appropriate follow-up instead of bilateral surgery would be justifiable in selected patients. These findings highlight the importance of shared-decision making in the management of patients with small, low-risk DTC.

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Total thyroidectomy versus thyroid lobectomy for papillary thyroid cancer: Comparative analysis after propensity score matching: A multicenter study

Abstract: Equivalent prognoses were observed for patients with 1- to 5-cm stage cN0 and cM0 PTC tumors treated by TL or TT after propensity score matching. Adverse events occurred less frequently in patients who underwent TL than TT.

Cited by 67 publications

References 20 publications

Long-Term Outcome after Hemithyroidectomy for Papillary Thyroid Cancer: A Comparative Study and Review of the Literature

Long-Term Outcome after Hemithyroidectomy for Papillary Thyroid Cancer: A Comparative Study and Review of the Literature

Thyroid Lobectomy for Low to Intermediate Risk Differentiated Thyroid Cancer

The Impact of the Extent of Surgery on the Long-Term Outcomes of Patients with Low-Risk Differentiated Non-Medullary Thyroid Cancer: A Systematic Meta-Analysis

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