Hemithyroidectomy vs. total thyroidectomy for minimally invasive follicular thyroid carcinoma: Quality of life and oncological outcomes

Abstract

Aim: To evaluate outcomes of patients following hemithyroidectomy (HT) vs. total thyroidectomy (TT) for minimally invasive follicular thyroid carcinomas (MI-FTCs).Patients and Methods: This is a retrospective analysis of 82 patients with unilateral MI-FTC that was conducted for cases operated between April 2015 and April 2019.A total of 42 and 40 patients were included in the HT and TT groups, respectively.The main outcomes were survival, metastasis and recurrence rates; procedurerelated complications and quality of life (QoL) 1 year after thyroidectomy.Results: Mean follow-up 36.3 ± 11.8 months; TT rendered significantly more complications. No recurrences, distant metastases or disease-specific deaths were observed in either group. Overall survival in the HT vs. TT group was 40/42 (95.2%) vs. 37/40 (92.5%), with P = .570. QoL was better in 5/8 SF-36v2 items in HT with no superiority for mean collective scores.Conclusions: HT has less morbidity and comparable survival, metastasis, recurrence and QoL with TT for MI-FTC. HT might be considered as a first-line option in the low-risk subgroup of MI-FTC; however, further research is needed to establish the ideal individualised approach.

Health-Related Quality of Life following Total Thyroidectomy and Lobectomy for Differentiated Thyroid Carcinoma: A Systematic Review

“…In this review, we identified 20 studies reporting on physical HrQoL following TT or HT [ 18 , 34 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 64 , 65 , 67 , 68 , 70 , 73 ] ( Table 5 ). Eight studies compared postoperative TT HrQoL with community reference values using seven different QoL instruments (i.e., SF-36, MFI-20, ThyPRO, PSQI, Billewicz Score, visual analog scale, and 15D) [ 18 , 34 , 51 , 53 , 55 , 58 , 61 , 68 ].…”

“…Finally, nine studies directly compared physical-related HrQoL for patients undergoing TT versus HT using six different questionnaires (EORTC-QLQ-C30, EORTC-QLQ-THY34, SF-36, THYCA-QoL, FoP-Q-SF, and KT-QoL) [ 52 , 56 , 57 , 59 , 60 , 62 , 64 , 65 , 67 ]. Four of these studies found decreased physical-related HrQoL following TT compared with HT for at least one of the following items: global physical subscale ( n = 1), voice symptoms ( n = 1), sensory symptoms ( n = 1), neuromuscular symptoms ( n = 1), vitality ( n = 1), and problems with scar ( n = 1) [ 57 , 59 , 64 , 67 ].…”

“…Finally, nine studies directly compared physical-related HrQoL for patients undergoing TT versus HT using six different questionnaires (EORTC-QLQ-C30, EORTC-QLQ-THY34, SF-36, THYCA-QoL, FoP-Q-SF, and KT-QoL) [ 52 , 56 , 57 , 59 , 60 , 62 , 64 , 65 , 67 ]. Four of these studies found decreased physical-related HrQoL following TT compared with HT for at least one of the following items: global physical subscale ( n = 1), voice symptoms ( n = 1), sensory symptoms ( n = 1), neuromuscular symptoms ( n = 1), vitality ( n = 1), and problems with scar ( n = 1) [ 57 , 59 , 64 , 67 ]. One study found a transitory impairment in physical function, fatigue, pain, neuromuscular symptoms, vocal symptoms, libido, feeling chilly, or tingling symptoms in TT patients compared with HT patients between one and three months following surgery, although this difference was no longer significant at six months postoperatively.…”

“…In this review, 19 studies reporting on psychological-related HrQoL were identified [ 18 , 34 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 63 , 64 , 65 , 67 , 68 , 73 ]. Eight of these studies assessed postoperative TT HrQoL in comparison with community reference values using six different instruments (SF-36, MFI-20, HADS, SDQ, Thy-PRO, 15D) [ 18 , 34 , 51 , 53 , 55 , 58 , 61 , 68 ].…”

“…Finally, ten studies directly compared psychological-related HrQoL in TT and HT patients [ 52 , 56 , 57 , 59 , 60 , 62 , 63 , 64 , 65 , 67 ]. Four of these studies found no significant difference between groups for psychological-related HrQoL [ 57 , 60 , 64 , 67 ].…”