Completion thyroidectomy in patients diagnosed with papillary thyroid cancer: is there a predictive factor for contralateral lobe tumor?

Abstract

T hyroid nodules are one of the most common endocrine pathologies in adult populations and can be diagnosed by physical examination (4%-8%), ultrasonographic examination (10%-41%), and autopsy (50%).[1] Though the majority of these nodules are benign, thyroid carcinoma is detected in approximately 5% of the cases. [2,3] Papillary thyroid cancer (PTC) is the most frequent histological subtype of thyroid cancer, and the incidence of PTC increases over the years.[4] It usually has an indolent course, rarely showing aggressive behavior. Although PTC prognosis is good, Objectives: Completion thyroidectomy (CT) is defined as the removal of the residual thyroid tissue in the case of detected malignancy after lobectomy for an indeterminate or non-diagnostic biopsy. Factors such as tumor diameter, aggressive histology, extrathyroidal spread, and positive surgical margin in papillary thyroid cancer (PTC) constitute CT indications. However, the type of surgery is controversial especially in patients with a tumor diameter of 1-4 cm. Determination of predictive factors for contralateral lobe tumors (CLTs) in PTC may be helpful for rough or excessive treatment of patients with this common thyroid pathology. The aim of the present study was to determine the predictive factors and rate of detection of CLTs after CT in patients with papillary thyroid carcinoma after lobectomy. Methods: Medical records of patients who underwent lobectomy with the final histological diagnosis of papillary thyroid carcinoma for the study period 2011 to 2016 were reviewed. Demographic data of the patients, diameter, multicentricity and subtype of tumor, extrathyroidal spread, and vascular invasion rate were obtained. Patients were divided into 2 groups as final histological examination after CT revealed benign (Group 1) and malignant (Group 2). Results: Data of 49 patients were retrospectively analyzed during the study period. The female-to-male ratio was 33/16. The mean age of the patients was 47.59 (23-77) years. Groups 1 and 2 consisted of 30 and 19 patients, respectively. No significant difference was found between the two groups regarding demographic data and tumor characteristics. Conclusion: Despite the fact that we have not been detecting any predictive factor in predicting the presence of tumor on the contralateral lobe in our study, the detection of a tumor on the contralateral lobe is frequent.