Predictive Factors Indicative of Hemithyroidectomy and Close Follow-Up versus Bilateral Total Thyroidectomy for Aggressive Variants of Papillary Thyroid Cancer
The diagnostic and treatment rates of early thyroid cancer have been increasing, including those of aggressive variants of papillary thyroid cancer (AVPTC). This study aimed to analyze the need for completion total thyroidectomy after lobectomy for clinically low-to-intermediate-risk AVPTC. Overall,...
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MDPI AG
2022-06-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/11/2757 |
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| author | In A Lee Gilseong Moon Seokmin Kang Kang Hee Lee Sun Min Lee Jin Kyong Kim Cho Rok Lee Sang-Wook Kang Jong Ju Jeong Kee-Hyun Nam Woong Youn Chung |
| author_facet | In A Lee Gilseong Moon Seokmin Kang Kang Hee Lee Sun Min Lee Jin Kyong Kim Cho Rok Lee Sang-Wook Kang Jong Ju Jeong Kee-Hyun Nam Woong Youn Chung |
| author_sort | In A Lee |
| collection | DOAJ |
| description | The diagnostic and treatment rates of early thyroid cancer have been increasing, including those of aggressive variants of papillary thyroid cancer (AVPTC). This study aimed to analyze the need for completion total thyroidectomy after lobectomy for clinically low-to-intermediate-risk AVPTC. Overall, 249 patients who underwent hemithyroidectomy (HT, n = 46) or bilateral total thyroidectomy (BTT, n = 203) for AVPTC between November 2005 and December 2019 at our single institution were examined. The average follow-up period was 14.9 years, with a recurrence rate of 4.3% and 10.8% in the HT and BTT groups, respectively. Multivariate Cox analysis revealed that palpable tumor on the neck during evaluation (HR, 2.7; 95% CI, 1.1–6.4; <i>p</i> = 0.025), clinical N1b (HR, 8.3; 95% CI, 1.1–63.4; <i>p</i> = 0.041), tumor size (cm) (HR, 1.3; 95% CI, 1.0–1.7; <i>p</i> = 0.036), gross extrathyroidal extension (HR, 3.1; 95% CI, 1.4–7.0; <i>p</i> = 0.007), and pathologic T3b (HR, 3.4; 95% CI, 1.0–11.4; <i>p</i> = 0.045) or T4a (HR, 6.0; 95% CI, 1.9–18.8; <i>p</i> = 0.002) were associated with an increased risk of recurrence. Incidentalomas identified during diagnosis had a significantly lower risk of recurrence (HR, 0.4; 95% CI, 0.2–0.9; <i>p</i> = 0.033). Close follow-up may be performed without completion total thyroidectomy for AVPTC found incidentally after HT. |
| first_indexed | 2024-03-10T01:26:01Z |
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| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T01:26:01Z |
| publishDate | 2022-06-01 |
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| spelling | doaj.art-8d306f514fcd4afd8cb5338bdf2b4fb02023-11-23T13:50:38ZengMDPI AGCancers2072-66942022-06-011411275710.3390/cancers14112757Predictive Factors Indicative of Hemithyroidectomy and Close Follow-Up versus Bilateral Total Thyroidectomy for Aggressive Variants of Papillary Thyroid CancerIn A Lee0Gilseong Moon1Seokmin Kang2Kang Hee Lee3Sun Min Lee4Jin Kyong Kim5Cho Rok Lee6Sang-Wook Kang7Jong Ju Jeong8Kee-Hyun Nam9Woong Youn Chung10Department of Surgery, College of Medicine, Severance Hospital, Yonsei University, Seoul 03722, KoreaDepartment of Surgery, College of Medicine, Severance Hospital, Yonsei University, Seoul 03722, KoreaDepartment of Surgery, College of Medicine, Severance Hospital, Yonsei University, Seoul 03722, KoreaDepartment of Surgery, College of Medicine, Severance Hospital, Yonsei University, Seoul 03722, KoreaDepartment of Surgery, College of Medicine, Severance Hospital, Yonsei University, Seoul 03722, KoreaDepartment of Surgery, College of Medicine, Severance Hospital, Yonsei University, Seoul 03722, KoreaDepartment of Surgery, Yongin Severance Hospital, Yongin-si 16995, KoreaDepartment of Surgery, College of Medicine, Severance Hospital, Yonsei University, Seoul 03722, KoreaDepartment of Surgery, College of Medicine, Severance Hospital, Yonsei University, Seoul 03722, KoreaDepartment of Surgery, College of Medicine, Severance Hospital, Yonsei University, Seoul 03722, KoreaDepartment of Surgery, College of Medicine, Severance Hospital, Yonsei University, Seoul 03722, KoreaThe diagnostic and treatment rates of early thyroid cancer have been increasing, including those of aggressive variants of papillary thyroid cancer (AVPTC). This study aimed to analyze the need for completion total thyroidectomy after lobectomy for clinically low-to-intermediate-risk AVPTC. Overall, 249 patients who underwent hemithyroidectomy (HT, n = 46) or bilateral total thyroidectomy (BTT, n = 203) for AVPTC between November 2005 and December 2019 at our single institution were examined. The average follow-up period was 14.9 years, with a recurrence rate of 4.3% and 10.8% in the HT and BTT groups, respectively. Multivariate Cox analysis revealed that palpable tumor on the neck during evaluation (HR, 2.7; 95% CI, 1.1–6.4; <i>p</i> = 0.025), clinical N1b (HR, 8.3; 95% CI, 1.1–63.4; <i>p</i> = 0.041), tumor size (cm) (HR, 1.3; 95% CI, 1.0–1.7; <i>p</i> = 0.036), gross extrathyroidal extension (HR, 3.1; 95% CI, 1.4–7.0; <i>p</i> = 0.007), and pathologic T3b (HR, 3.4; 95% CI, 1.0–11.4; <i>p</i> = 0.045) or T4a (HR, 6.0; 95% CI, 1.9–18.8; <i>p</i> = 0.002) were associated with an increased risk of recurrence. Incidentalomas identified during diagnosis had a significantly lower risk of recurrence (HR, 0.4; 95% CI, 0.2–0.9; <i>p</i> = 0.033). Close follow-up may be performed without completion total thyroidectomy for AVPTC found incidentally after HT.https://www.mdpi.com/2072-6694/14/11/2757aggressive variants of papillary thyroid cancerhemithyroidectomyfollow-upthyroidectomyhemithyroidectomy |
| spellingShingle | In A Lee Gilseong Moon Seokmin Kang Kang Hee Lee Sun Min Lee Jin Kyong Kim Cho Rok Lee Sang-Wook Kang Jong Ju Jeong Kee-Hyun Nam Woong Youn Chung Predictive Factors Indicative of Hemithyroidectomy and Close Follow-Up versus Bilateral Total Thyroidectomy for Aggressive Variants of Papillary Thyroid Cancer Cancers aggressive variants of papillary thyroid cancer hemithyroidectomy follow-up thyroidectomy hemithyroidectomy |
| title | Predictive Factors Indicative of Hemithyroidectomy and Close Follow-Up versus Bilateral Total Thyroidectomy for Aggressive Variants of Papillary Thyroid Cancer |
| title_full | Predictive Factors Indicative of Hemithyroidectomy and Close Follow-Up versus Bilateral Total Thyroidectomy for Aggressive Variants of Papillary Thyroid Cancer |
| title_fullStr | Predictive Factors Indicative of Hemithyroidectomy and Close Follow-Up versus Bilateral Total Thyroidectomy for Aggressive Variants of Papillary Thyroid Cancer |
| title_full_unstemmed | Predictive Factors Indicative of Hemithyroidectomy and Close Follow-Up versus Bilateral Total Thyroidectomy for Aggressive Variants of Papillary Thyroid Cancer |
| title_short | Predictive Factors Indicative of Hemithyroidectomy and Close Follow-Up versus Bilateral Total Thyroidectomy for Aggressive Variants of Papillary Thyroid Cancer |
| title_sort | predictive factors indicative of hemithyroidectomy and close follow up versus bilateral total thyroidectomy for aggressive variants of papillary thyroid cancer |
| topic | aggressive variants of papillary thyroid cancer hemithyroidectomy follow-up thyroidectomy hemithyroidectomy |
| url | https://www.mdpi.com/2072-6694/14/11/2757 |
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