Hemithyroidectomy for low-risk follicular carcinoma of the thyroid: results from a regional hospital

Chow, Tam‐Lin; Tam, Susanna Wai-Yin; Choi, Chi‐Yee; Kwan, Wilson W.Y.

doi:10.11622/smedj.2017106

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…In line with the authors’ opinion, I have declared that I am a partisan advocate of hemithyroidectomy for low-risk DTC. Nevertheless, I have some comments on the article by Nickel et al First, the authors have not lucidly described whether central compartment dissection was performed in addition to total thyroidectomy.…”

supporting

confidence: 59%

Quality of Life After Surgical Treatment for Thyroid Cancer

Chow

2019

JAMA Otolaryngol Head Neck Surg

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supporting

confidence: 59%

Quality of Life After Surgical Treatment for Thyroid Cancer

Chow

2019

JAMA Otolaryngol Head Neck Surg

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“…Whether these patients require completion thyroidectomy or further RAI is controversial. Some surgeons advocate that TT should be recommended for all patients with FTC because of its high risk of distant metastases [5][6][7], while others thought routine completion thyroidectomy and RAI were unnecessary because they found that the extent of surgery had no significant influence on the prognosis of low-risk FTC [8][9][10]. The recent American Thyroid Association (ATA) guidelines recommend that LT may be an adequate primary surgical procedure for low-risk PTC and FTC with a tumor size not exceeding 40 mm, while a near-total or TT should be the initial treatment for PTC and FTC patients with tumor size [ 40 mm [11].…”

Section: Introductionmentioning

confidence: 99%

Impact of Extent of Surgery on Long‐Term Prognosis of Follicular Thyroid Carcinoma Without Extrathyroidal Extension and Distant Metastasis

et al. 2021

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Aim To analyze the effect of total thyroidectomy (TT) and thyroid lobectomy (LT) on the long-term prognosis of follicular thyroid carcinoma (FTC) without extrathyroidal extension and distant metastasis and to clarify whether the tumor size (B 40 mm vs. [ 40 mm) has an important impact on the extent of surgery. Methods Data on FTC patients without extrathyroidal extension and distant metastasis treated with either TT or LT between 1998 and 2016 were extracted from the Surveillance, Epidemiology, and End Results Database. Propensity score matching was performed to minimize impact of selection bias and potential confounding. Kaplan-Meier curves and Cox regression analysis were conducted to assess the impact of the extent of surgery on disease-specific survival (DSS). Results A total of 8435 patients were identified. The DSS after LT were 100%, 98.3%, and 97.6% at 5, 10, and 15 years, respectively, compared with those seen after TT of 99.3%, 97.9%, and 96.6%. The difference between the two groups is not statistically significant (p = 0.083). Similar results were observed in cohorts after adjusting for baseline covariates. There was also similar prognosis between LT and TT in patients with tumors size B 40 mm or [ 40 mm. Conclusions For patients with FTC of any size without extrathyroidal extension and distant metastases at diagnosis, TT and LT confer equivalent DSS. Completion thyroidectomy after LT may be not necessary unless patients relapse; however, recurrence rates and development of metastases are not evaluated in this study.

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“…Thyroglobulin (Tg) was used as a tumor marker for surveillance. Although monitoring with Tg following total thyroidectomy is widely practiced, its usage or benefit is dubious for lobectomy . Would the authors elaborate the efficacy of Tg for thyroid cancer after partial thyroidectomy?…”

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confidence: 99%

Monitoring Thyroglobulin Following Total Thyroidectomy After Lobectomy

Chow

2024

JAMA Otolaryngol Head Neck Surg

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including frailty, general balance, and mobility, as well as the capacity and willingness to adhere to the recommended PT regimen during and after therapy sessions at home as important covariates. 2 At the same time, we acknowledge constraints in assessing these variables in our analyses due to their unavailability in the administrative dataset we used. We agree with the authors on the necessity for further research to elucidate how these variables may affect PT use and the effects of PT for patients experiencing dizziness.Wu and colleagues reference a 2022 commentary 3 highlighting limitations of using the Charlson Comorbidity Index (CCI), a weighted index, rather than specific individual diagnoses to measure comorbidity, particularly for assessing risk of death or survival time in patients with cancer. We acknowledge the imperfections of grouping predefined comorbidities and the limitations of indices including CCI to capture the full spectrum of patient-specific comorbidities. Despite these imperfections, the CCI remains the most widely used comorbidity index, boasting more than 10 000 citations. Its appeal, especially in administrative studies like ours, 1 lies in its utility and generalizability for large cohorts and its adaptability for use with administrative data. 4,5 We concur with Wu and colleagues that additional work is warranted. The association we observed in the cohort between PT and falls among individuals with dizziness was robust at all time points, and yet inclusion of the variables proposed by our colleagues would add important and practical clinical nuance. Specifically, we propose that future research, ideally using a clinical trial design, is necessary to explore the independent effect of PT on the risk of subsequent falls for adults experiencing dizziness. A prospective trial would best facilitate the measurement of patient-specific covariates of interest that are not captured in claims data. We also contend that further investigation is required to delineate the specific components of PT, such as particular exercises, education, timing and frequency of sessions, duration of therapy, and adherence that are most beneficial.

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Hemithyroidectomy for low-risk follicular carcinoma of the thyroid: results from a regional hospital

Abstract: Introduction: Excellent outcome after conservative thyroid surgery for low-risk follicular

Cited by 4 publications

References 22 publications

Quality of Life After Surgical Treatment for Thyroid Cancer

Quality of Life After Surgical Treatment for Thyroid Cancer

Impact of Extent of Surgery on Long‐Term Prognosis of Follicular Thyroid Carcinoma Without Extrathyroidal Extension and Distant Metastasis

Monitoring Thyroglobulin Following Total Thyroidectomy After Lobectomy

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