Background: There remains controversy over the type of surgery appropriate for T1T2N0 well differentiated thyroid cancers (WDTC). Current guidelines recommend total thyroidectomy for all but the smallest lesions, despite previous evidence from large institutions suggesting that lobectomy provides similar excellent results. The objective of this study was to report our experience of T1T2N0 WDTC managed by either thyroid lobectomy or total thyroidectomy.
Methods: Eight hundred eighty-nine patients with pT1T2 intrathyroid cancers treated surgically between 1986 and 2005 were identified from a database of 1810 patients with WDTC. Total thyroidectomy was carried out in 528 (59%) and thyroid lobectomy in 361 (41%) patients. Overall survival (OS), disease-specific survival (DSS) and recurrence-free survival (RFS) were determined by the Kaplan-Meier method. Factors predictive of outcome by univariate and multivariate analysis were determined using the log rank test and Cox proportional hazards method respectively.
Results: With a median follow-up of 99 months, the 10-yr OS, DSS, and RFS for all patients were 92%, 99%, and 98% respectively. Univariate analysis showed no significant difference in OS by extent of surgical resection. Multivariate analysis showed that age over 45 yr and male gender were independent predictors for poorer OS, whereas T stage and type of surgery were not. Comparison of the thyroid lobectomy group and the total thyroidectomy group showed no difference in local recurrence (0% for both) or regional recurrence (0% vs 0.8%, P = .96).
Conclusion: Patients with pT1T2 N0 WDTC can be safely managed by thyroid lobectomy alone.
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http://dx.doi.org/10.1016/j.surg.2011.08.016 | DOI Listing |
Auris Nasus Larynx
January 2025
Department of Otolaryngology Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama 700-8558, Japan.
Objective: An optimal surgical approach for intermediate-risk papillary thyroid cancer (PTC) has not yet been established. The surgical procedure should be determined based on treatment outcomes and postoperative complications. This study aimed to evaluate appropriate surgical strategies for patients with intermediate-risk PTC by comparing treatment outcomes and postoperative complications following total thyroidectomy and lobectomy.
View Article and Find Full Text PDFDiagnostics (Basel)
December 2024
Department of ENT and Head and Neck Surgery, University Hospital Center Zagreb, 10000 Zagreb, Croatia.
: Thyroidectomy, a surgical procedure for thyroid disorders, is associated with postoperative voice changes, even in cases without recurrent laryngeal nerve (RLN) injury. Our study evaluates the prevalence and predictors of voice disorders in thyroidectomy patients without RLN injury. : Our single-center prospective study at the University Hospital Center Zagreb included 243 patients, with pre- and postoperative voice evaluations using acoustic analysis and videostroboscopy.
View Article and Find Full Text PDFJ Clin Endocrinol Metab
January 2025
Department of Otolaryngology-Head and Neck Surgery, Beilinson Hospital, Rabin Medical Center.
Thyroid lobectomy has gained increasing popularity over the past decade as a treatment for differentiated thyroid cancer (DTC), largely due to a rise in the diagnosis of low-risk cancers and evidence showing no benefit from radioiodine in low-risk disease. Multiple studies have confirmed lobectomy as an effective and safe option. Its advantages over total thyroidectomy include lower complication rates and a reduced need for lifelong levothyroxine (LT4) therapy.
View Article and Find Full Text PDFSurgery
December 2024
Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, China. Electronic address:
Background: This study aimed to evaluate the prognostic outcomes of thyroidectomy extent in unilateral TNM T1 or T2 papillary thyroid carcinoma with lateral lymph node metastasis.
Methods: Retrospective data were collected from unilateral papillary thyroid carcinoma patients with unilateral lymph node metastasis who underwent surgery at Qilu Hospital of Shandong University from 2011 to 2022. Patients were categorized into 2 groups based on the extent of the thyroidectomy (total thyroidectomy versus lobectomy).
Ann Surg Oncol
December 2024
Department of General, Visceral, and Endocrine Surgery, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, Paris, France.
Background: The ATA guidelines suggest lobectomy as an option for select patients with thyroid cancer (TC), but some may need completion thyroidectomy because of unfavorable characteristics on the final pathology. This study aimed to compare postoperative morbidity of patients with TC who underwent total thyroidectomy in two steps (TT2) or one step (TT1).
Methods: This was a retrospective comparative study in a high-volume endocrine surgery center.
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