Completion Total Thyroidectomy Is Not Necessary for Papillary Thyroid Microcarcinoma with Occult Central Lymph Node Metastasis: A Long-Term Serial Follow-Up
The necessity of completion total thyroidectomy in patients with papillary thyroid microcarcinoma (PTMC) and pathological central lymph node metastasis (pCLNM) who underwent thyroid lobectomy with central compartment neck dissection (CCND) is unclear. We determined the necessity of completion total...
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MDPI AG
2020-10-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/10/3032 |
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| author | Soon Min Choi Jin Kyong Kim Cho Rok Lee Jandee Lee Jong Ju Jeong Kee-Hyun Nam Woong Youn Chung Sang-Wook Kang |
| author_facet | Soon Min Choi Jin Kyong Kim Cho Rok Lee Jandee Lee Jong Ju Jeong Kee-Hyun Nam Woong Youn Chung Sang-Wook Kang |
| author_sort | Soon Min Choi |
| collection | DOAJ |
| description | The necessity of completion total thyroidectomy in patients with papillary thyroid microcarcinoma (PTMC) and pathological central lymph node metastasis (pCLNM) who underwent thyroid lobectomy with central compartment neck dissection (CCND) is unclear. We determined the necessity of completion total thyroidectomy by retrospectively comparing the prognosis according to the presence of pCLNM during a long-term follow-up. We enrolled 876 patients with PTMC who underwent thyroid lobectomy with prophylactic CCND from January 1986 to December 2009. Patients were divided according to central lymph node (CLN) metastasis: 165 (18.8%) and 711 (81.2%) in the CLN-positive and CLN-negative groups, respectively. Medical records were reviewed retrospectively, and clinicopathologic characteristics and recurrence rates were analyzed. The CLN-positive group was associated with male sex (<i>p</i> = 0.001), larger tumor size (<i>p</i> < 0.001), and more microscopic capsular invasion (<i>p</i> < 0.001) compared with the CLN-negative group. There was no significant difference between the two groups’ recurrence (<i>p</i> = 0.133) or disease-free (<i>p</i> = 0.065) survival rates. Univariate and multivariate analyses showed no factors associated with tumor recurrence except male sex (hazard ratio = 3.043, confidence interval 1.117–8.288, <i>p</i> = 0.030). Patients who were diagnosed with pCLNM after undergoing thyroid lobectomy with prophylactic CCND do not require completion total thyroidectomy; however, frequent follow-up is necessary for patients with PTMC and pCLNM. |
| first_indexed | 2024-03-10T15:31:42Z |
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| id | doaj.art-9d58578b7e1f4bd4b5f1142176c50ebf |
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| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T15:31:42Z |
| publishDate | 2020-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-9d58578b7e1f4bd4b5f1142176c50ebf2023-11-20T17:35:16ZengMDPI AGCancers2072-66942020-10-011210303210.3390/cancers12103032Completion Total Thyroidectomy Is Not Necessary for Papillary Thyroid Microcarcinoma with Occult Central Lymph Node Metastasis: A Long-Term Serial Follow-UpSoon Min Choi0Jin Kyong Kim1Cho Rok Lee2Jandee Lee3Jong Ju Jeong4Kee-Hyun Nam5Woong Youn Chung6Sang-Wook Kang7Department of Surgery, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Surgery, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Surgery, Yong-In Severance Hospital, Yonsei University College of Medicine, Yong-In 16995, KoreaDepartment of Surgery, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Surgery, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Surgery, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Surgery, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Surgery, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul 03722, KoreaThe necessity of completion total thyroidectomy in patients with papillary thyroid microcarcinoma (PTMC) and pathological central lymph node metastasis (pCLNM) who underwent thyroid lobectomy with central compartment neck dissection (CCND) is unclear. We determined the necessity of completion total thyroidectomy by retrospectively comparing the prognosis according to the presence of pCLNM during a long-term follow-up. We enrolled 876 patients with PTMC who underwent thyroid lobectomy with prophylactic CCND from January 1986 to December 2009. Patients were divided according to central lymph node (CLN) metastasis: 165 (18.8%) and 711 (81.2%) in the CLN-positive and CLN-negative groups, respectively. Medical records were reviewed retrospectively, and clinicopathologic characteristics and recurrence rates were analyzed. The CLN-positive group was associated with male sex (<i>p</i> = 0.001), larger tumor size (<i>p</i> < 0.001), and more microscopic capsular invasion (<i>p</i> < 0.001) compared with the CLN-negative group. There was no significant difference between the two groups’ recurrence (<i>p</i> = 0.133) or disease-free (<i>p</i> = 0.065) survival rates. Univariate and multivariate analyses showed no factors associated with tumor recurrence except male sex (hazard ratio = 3.043, confidence interval 1.117–8.288, <i>p</i> = 0.030). Patients who were diagnosed with pCLNM after undergoing thyroid lobectomy with prophylactic CCND do not require completion total thyroidectomy; however, frequent follow-up is necessary for patients with PTMC and pCLNM.https://www.mdpi.com/2072-6694/12/10/3032papillary thyroid microcarcinomacompletion total thyroidectomycentral lymph node metastasisrecurrence |
| spellingShingle | Soon Min Choi Jin Kyong Kim Cho Rok Lee Jandee Lee Jong Ju Jeong Kee-Hyun Nam Woong Youn Chung Sang-Wook Kang Completion Total Thyroidectomy Is Not Necessary for Papillary Thyroid Microcarcinoma with Occult Central Lymph Node Metastasis: A Long-Term Serial Follow-Up Cancers papillary thyroid microcarcinoma completion total thyroidectomy central lymph node metastasis recurrence |
| title | Completion Total Thyroidectomy Is Not Necessary for Papillary Thyroid Microcarcinoma with Occult Central Lymph Node Metastasis: A Long-Term Serial Follow-Up |
| title_full | Completion Total Thyroidectomy Is Not Necessary for Papillary Thyroid Microcarcinoma with Occult Central Lymph Node Metastasis: A Long-Term Serial Follow-Up |
| title_fullStr | Completion Total Thyroidectomy Is Not Necessary for Papillary Thyroid Microcarcinoma with Occult Central Lymph Node Metastasis: A Long-Term Serial Follow-Up |
| title_full_unstemmed | Completion Total Thyroidectomy Is Not Necessary for Papillary Thyroid Microcarcinoma with Occult Central Lymph Node Metastasis: A Long-Term Serial Follow-Up |
| title_short | Completion Total Thyroidectomy Is Not Necessary for Papillary Thyroid Microcarcinoma with Occult Central Lymph Node Metastasis: A Long-Term Serial Follow-Up |
| title_sort | completion total thyroidectomy is not necessary for papillary thyroid microcarcinoma with occult central lymph node metastasis a long term serial follow up |
| topic | papillary thyroid microcarcinoma completion total thyroidectomy central lymph node metastasis recurrence |
| url | https://www.mdpi.com/2072-6694/12/10/3032 |
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