Efficacy of hemithyroidectomy in papillary thyroid carcinoma with minimal extrathyroidal extension

Yong Bae Ji, Chang Myeon Song, Donghwan Kim, Eui Suk Sung, Dong Won Lee, Min Sung Chung, Kyung Tae

Research output: Contribution to journalArticle

Abstract

Purpose: This study aimed to compare the oncologic outcomes of hemithyroidectomy with total thyroidectomy in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) with minimal extrathyroidal extension (ETE). Methods: Among 1826 PTC patients who underwent thyroidectomy from Jan 2001 to Dec 2014, there were 255 with unilateral cN0 PTC with minimal ETE and of equal to or less than 2 cm in size; these 255 patients were included in this study. We excluded patients who had tumor size > 2 cm, bilateral tumors, clinically positive nodes, maximal or no ETE, gross invasion of sternothyroid muscle, recurrent cancers or distant metastases. Total thyroidectomy was performed in 173 of the 255 patients, and hemithyroidectomy in 82 of them. A propensity score-matched analysis was carried out to reduce selection bias, with the following covariates: sex, age, tumor size, multiplicity and central neck dissection. Results: In the baseline data of the 255 patients, female, age and tumor size were significantly higher in the total thyroidectomy group as was Stage III, whereas T and N classification did not differ in the two groups. Propensity score matching generated two matched groups of 66 patients each, in which the significant differences between the two groups seen in the baseline analysis disappeared. In the matched samples, recurrence rate (3.0% vs. 1.5%, p = 1.0) and recurrence-free survival curves did not differ between total thyroidectomy and hemithyroidectomy. Conclusions: Hemithyroidectomy can be recommended for cN0 PTC 1 cm or less with minimal ETE. Also it can be considered for cN0 PTC 11–20 mm with minimal ETE.

Original languageEnglish
JournalEuropean Archives of Oto-Rhino-Laryngology
DOIs
StateAccepted/In press - 2019 Jan 1

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Thyroidectomy
Propensity Score
Neoplasms
Muscle Neoplasms
Recurrence
Neck Dissection
Selection Bias
Papillary Thyroid cancer
Research Design
Neoplasm Metastasis
Survival

Keywords

  • Extrathyroidal extension
  • Hemithyroidectomy
  • Papillary thyroid carcinoma
  • Propensity score matching
  • Recurrence

Cite this

@article{cabc071ee61d410db1c588bfc6bff4a7,
title = "Efficacy of hemithyroidectomy in papillary thyroid carcinoma with minimal extrathyroidal extension",
abstract = "Purpose: This study aimed to compare the oncologic outcomes of hemithyroidectomy with total thyroidectomy in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) with minimal extrathyroidal extension (ETE). Methods: Among 1826 PTC patients who underwent thyroidectomy from Jan 2001 to Dec 2014, there were 255 with unilateral cN0 PTC with minimal ETE and of equal to or less than 2 cm in size; these 255 patients were included in this study. We excluded patients who had tumor size > 2 cm, bilateral tumors, clinically positive nodes, maximal or no ETE, gross invasion of sternothyroid muscle, recurrent cancers or distant metastases. Total thyroidectomy was performed in 173 of the 255 patients, and hemithyroidectomy in 82 of them. A propensity score-matched analysis was carried out to reduce selection bias, with the following covariates: sex, age, tumor size, multiplicity and central neck dissection. Results: In the baseline data of the 255 patients, female, age and tumor size were significantly higher in the total thyroidectomy group as was Stage III, whereas T and N classification did not differ in the two groups. Propensity score matching generated two matched groups of 66 patients each, in which the significant differences between the two groups seen in the baseline analysis disappeared. In the matched samples, recurrence rate (3.0{\%} vs. 1.5{\%}, p = 1.0) and recurrence-free survival curves did not differ between total thyroidectomy and hemithyroidectomy. Conclusions: Hemithyroidectomy can be recommended for cN0 PTC 1 cm or less with minimal ETE. Also it can be considered for cN0 PTC 11–20 mm with minimal ETE.",
keywords = "Extrathyroidal extension, Hemithyroidectomy, Papillary thyroid carcinoma, Propensity score matching, Recurrence",
author = "Ji, {Yong Bae} and Song, {Chang Myeon} and Donghwan Kim and Sung, {Eui Suk} and Lee, {Dong Won} and Chung, {Min Sung} and Kyung Tae",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s00405-019-05598-z",
language = "English",
journal = "European Archives of Oto-Rhino-Laryngology",
issn = "0937-4477",

}

TY - JOUR

T1 - Efficacy of hemithyroidectomy in papillary thyroid carcinoma with minimal extrathyroidal extension

AU - Ji, Yong Bae

AU - Song, Chang Myeon

AU - Kim, Donghwan

AU - Sung, Eui Suk

AU - Lee, Dong Won

AU - Chung, Min Sung

AU - Tae, Kyung

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: This study aimed to compare the oncologic outcomes of hemithyroidectomy with total thyroidectomy in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) with minimal extrathyroidal extension (ETE). Methods: Among 1826 PTC patients who underwent thyroidectomy from Jan 2001 to Dec 2014, there were 255 with unilateral cN0 PTC with minimal ETE and of equal to or less than 2 cm in size; these 255 patients were included in this study. We excluded patients who had tumor size > 2 cm, bilateral tumors, clinically positive nodes, maximal or no ETE, gross invasion of sternothyroid muscle, recurrent cancers or distant metastases. Total thyroidectomy was performed in 173 of the 255 patients, and hemithyroidectomy in 82 of them. A propensity score-matched analysis was carried out to reduce selection bias, with the following covariates: sex, age, tumor size, multiplicity and central neck dissection. Results: In the baseline data of the 255 patients, female, age and tumor size were significantly higher in the total thyroidectomy group as was Stage III, whereas T and N classification did not differ in the two groups. Propensity score matching generated two matched groups of 66 patients each, in which the significant differences between the two groups seen in the baseline analysis disappeared. In the matched samples, recurrence rate (3.0% vs. 1.5%, p = 1.0) and recurrence-free survival curves did not differ between total thyroidectomy and hemithyroidectomy. Conclusions: Hemithyroidectomy can be recommended for cN0 PTC 1 cm or less with minimal ETE. Also it can be considered for cN0 PTC 11–20 mm with minimal ETE.

AB - Purpose: This study aimed to compare the oncologic outcomes of hemithyroidectomy with total thyroidectomy in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) with minimal extrathyroidal extension (ETE). Methods: Among 1826 PTC patients who underwent thyroidectomy from Jan 2001 to Dec 2014, there were 255 with unilateral cN0 PTC with minimal ETE and of equal to or less than 2 cm in size; these 255 patients were included in this study. We excluded patients who had tumor size > 2 cm, bilateral tumors, clinically positive nodes, maximal or no ETE, gross invasion of sternothyroid muscle, recurrent cancers or distant metastases. Total thyroidectomy was performed in 173 of the 255 patients, and hemithyroidectomy in 82 of them. A propensity score-matched analysis was carried out to reduce selection bias, with the following covariates: sex, age, tumor size, multiplicity and central neck dissection. Results: In the baseline data of the 255 patients, female, age and tumor size were significantly higher in the total thyroidectomy group as was Stage III, whereas T and N classification did not differ in the two groups. Propensity score matching generated two matched groups of 66 patients each, in which the significant differences between the two groups seen in the baseline analysis disappeared. In the matched samples, recurrence rate (3.0% vs. 1.5%, p = 1.0) and recurrence-free survival curves did not differ between total thyroidectomy and hemithyroidectomy. Conclusions: Hemithyroidectomy can be recommended for cN0 PTC 1 cm or less with minimal ETE. Also it can be considered for cN0 PTC 11–20 mm with minimal ETE.

KW - Extrathyroidal extension

KW - Hemithyroidectomy

KW - Papillary thyroid carcinoma

KW - Propensity score matching

KW - Recurrence

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U2 - 10.1007/s00405-019-05598-z

DO - 10.1007/s00405-019-05598-z

M3 - Article

AN - SCOPUS:85070949767

JO - European Archives of Oto-Rhino-Laryngology

JF - European Archives of Oto-Rhino-Laryngology

SN - 0937-4477

ER -