A meta-analysis on the effect of operation modes on the recurrence of papillary thyroid microcarcinoma

Abstract

Whether total thyroidectomy reduces the recurrence rate in patients with papillary thyroid microcarcinoma (PTMC) is currently controversy. Conclusions of sporadic, inconsistent, and mono-institutional studies need a meta-analysis to evaluate. 525 relevant studies were obtained from initial search on PubMed, 511 studies were excluded by inclusion and exclusion criteria. Eligible data were extracted from each included study. The Odds ratios (ORs) and 95% confidence interval (CI) were used to assess the difference in the recurrence rates between PTMC patients treated with total thyroidectomy and non-total thyroidectomy. OR and 95% CI were calculated using a fixed-effects or a random-effects model. The Q statistic was used to evaluate homogeneity and Beggs test was used to assess publication bias. 14 studies meeting the inclusion criteria were included in this meta-analysis. The over all recurrence rates of pooled patients with total thyroidectomy and non-total thyroidectomy were 2.83% and 2.84% respectively. Primary random-effects model analysis showed, no significant difference of recurrence rates existed between two operation modes (OR = 0.732, 95% CI: 0.444 - 1.208), while, high heterogeneity among studies was found, I-squared index (I2) = 40.2%. After remove one study with high heterogeneity, the OR of the pooled recurrence rates of the total thyroidectomy and the non-total thyroidectomy groups was 0.786 (95% CI: 0.363 - 1.701), further suggesting no significant difference of the recurrence rate exists between two operation modes. Our meta-analysis demonstrated postoperative recurrence of PTMC is not reduced by total thyroidectomy, non-total thyroidectomy is also a good choice to treat PTMC patients.

Predictive Factors of Recurrence of Papillary Thyroid Microcarcinomas: Analysis of 2,538 Patients

“…34 In general, recurrence of cancer is not frequently observed following thyroidectomy for PTMC. In a meta-analysis including 6,839 PTMC patients, Yi et al 35 found a low recurrence rate (2.8%), very similar to ours (2.5%). However, recurrence rates as high as 14.3% and 19% have been described in the literature.…”

Hashimoto’s thyroiditis, nodular goiter or follicular adenoma combined with papillary thyroid carcinoma play protective role in patients

“…PTMC usually has an excellent prognosis [24], postoperative recurrence of PTMC is not reduced by total thyroidectomy. Non-total thyroidectomy is also a good choice for treatment of PTMC patients [25].…”

Associations of BRAF V600E, clinical pathology and imaging factors with the recurrence rate of papillary thyroid microcarcinoma

“…In recent years, the frequency of PTMC has rapidly risen and its morbidity has markedly increased (16). Although the requirement for surgery in the treatment of PTMC is debated, surgical management of nodal metastasis of PTMC is undisputed and the rate of nodal metastasis is high (16).…”

“…In recent years, the frequency of PTMC has rapidly risen and its morbidity has markedly increased (16). Although the requirement for surgery in the treatment of PTMC is debated, surgical management of nodal metastasis of PTMC is undisputed and the rate of nodal metastasis is high (16). For instance, the reported rates of central lymph node metastasis alone range from 24 to 64% and its occurrence is associated with recurrence and death rates (19,20).…”

“…The presence of the BRAF V600E mutation is closely associated with papillary carcinoma recurrence and patient mortality. In addition, numerous patients choose surgical treatment for PTMC due to the high morbidity rate (15) However, certain patients develop recurrent PTMC postoperatively (16). This study focused on BRAF V600E, clinical pathology and imaging factors to explore their associations with PTMC recurrence.…”