Natural History of Contralateral Nodules After Lobectomy in Patients With Papillary Thyroid Carcinoma

Ritter, Amit; Bachar, Gideon; Hirsch, Dania; Benbassat, Carlos; Katz, Odelia; Kochen, Nadav; Diker-Cohen, Talia; Akirov, Amit; Shimon, Ilan; Robenshtok, Eyal

doi:10.1210/jc.2017-01616

Cited by 17 publications

(19 citation statements)

References 42 publications

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“…The current controversy on the extent of surgery probably rises from the heterogeneity in aims and design among studies. The varied aims included were: survival [6,12,15,16,17,18,19,20], multifocality [8,25,30,33], need for hormone replacement [7,34], contralateral nodules or completion for indeterminate cytology [28,33,35,36], among others. Nevertheless, by using propensity score matching, two recent studies found that the extension of surgery has no impact on disease outcomes.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcome after Hemithyroidectomy for Papillary Thyroid Cancer: A Comparative Study and Review of the Literature

Geron

Benbassat

Shteinshneider

et al. 2018

Cancers

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Background: The extent of surgery for differentiated thyroid cancer (DTC) remains a controversial issue. Since a less aggressive approach is becoming more predominant, we aim here to study the short- and long-term outcomes of DTC patients after hemithyroidectomy. Methods: From a total of 1252 consecutive papillary thyroid cancer (PTC) patients, 109 treated with hemithyroidectomy and 50 with total thyroidectomy but no I131 were included. Persistent or recurrent disease was defined based on histopathology, imaging studies, and thyroglobulin levels. Results: Our hemithyroidectomy cohort included females (84.4%), microcarcinomas (81.9%), TNM stage I (95.4%), and a low American Thyroid Association (ATA) recurrence risk (94.5%). At one-year post-treatment, 3.7% had persistent disease (all female, median age 55 years, tumor size 7.5 mm). Recurrent disease was detected in 7.5% of those with excellent response at 1-year. With a follow-up of 8.6 years (1–48), all 109 patients were disease free at last visit, including the 11 patients (10.1%) who received additional treatment. Also, when comparing the hemi- and total thyroidectomy groups no significant differences were found in the rate of persistent and recurrent disease, overall mortality, and disease status at last visit. Conclusions: For properly selected low-risk PTC patients, hemithyroidectomy is a safe treatment option with a favorable long-term outcome.

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Section: Discussionmentioning

confidence: 99%

Long-Term Outcome after Hemithyroidectomy for Papillary Thyroid Cancer: A Comparative Study and Review of the Literature

Geron

Benbassat

Shteinshneider

et al. 2018

Cancers

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“…The rates of recurrence are low in patients treated with hemithyroidectomy: recurrence in the contralateral lobe was observed in about 5% of the cases (83,84,85,86) and lymph node recurrence in a percentage ranging between less than 1% and about 3% (83,85,86). No cases of distant recurrence are described when only a low-risk population is taken into account (83,85,86 treated with total thyroidectomy (83).…”

Section: Treatment Paradigm Shiftmentioning

confidence: 99%

“…No cases of distant recurrence are described when only a low-risk population is taken into account (83,85,86 treated with total thyroidectomy (83). The mean time interval from initial treatment and recurrence was 4 years in a study of 734 patients treated with hemithyroidectomy (85), but late recurrences are possible (84). The other cornerstone of DTC treatment is radioiodine treatment (RAI-T).…”

Section: Treatment Paradigm Shiftmentioning

confidence: 99%

Follow-up of low risk thyroid cancer patients: can we stop follow-up after 5 years of complete remission?

Lamartina

Handkiewicz-Junak

2020

European Journal of Endocrinology

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Each year, the proportion of thyroid cancer patients presenting with low-risk disease is increasing. The shift in the landscape of thyroid cancer presentation is forcing clinicians to re-evaluate not only management but also surveillance paradigms. During the follow-up, patients are stratified considering their response to treatment and classified into one of the following response categories: excellent, biochemical incomplete, structural incomplete, or indeterminate. These categories reflect a real-time prognosis and thereby substantially influence and personalise disease management. Although at present, no guideline recommends stopping differentiated thyroid carcinoma (DTC) surveillance at any particular time point, the relatively low prevalence of treatment failures in low-risk patients may prompt early discontinuation of surveillance in this subgroup. Therefore, this debate will present an overview of the controversies surrounding the surveillance of low-risk patients with DTC.

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“…Somewhat worse prognosis is shown in cases of extirpation of a single thyroid lobe with a tumor (hemi-thyroidectomy): in some of such patients the risk of post-operative disease relapse in a remained lobe is probably higher. Such operation volume is declared to be acceptable only if the gland contralateral lobe is not damaged by the tumor [23]. The prognosis is also poorer in cases of thyroidectomy and lymph node dissection which are inevitable if the nodes are penetrated by thyroid gland tumor metastases, i.e.…”

Section: Groupsmentioning

confidence: 99%

Main Prognostic Factors for Well Differentiated Thyroid Cancer: Analis of Combined Patients Treatment Results during 20 Years after Surgery

Bb¹,

Ae²,

My³

et al. 2018

Thyroid Disorders Ther

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Background: In general, the prognosis in patients with well differentiated thyroid carcinoma (WDTC) is excellent. However, there are small cohorts of patients who experience a more aggressive form of disease which is often associated with certain poor prognostic factors. Identifying these patients at an early stage is imperative for guiding treatment decisions. The purpose of the work is to study the cumulative survival of patients with WDTC, depending on a number of clinical and biological characteristics of tumors. Methods: A retrospective cohort study of patients operated on WDTC in the period from 1995 to 2015 (5526 people). Each patient was analyzed according to age, gender, tumor size and characteristics of the TNM (7 editions), clinical stage, volume of surgery, number of points on the MACIS scale, risk group, number of courses of radioiodine treatment, result treatment and the term of postoperative observation. The construction of cumulative survival curves was made according to the Kaplan-Meier approach. To compare the cumulative survival index value in groups, the non-parametric Log-rank test was used. Results: The most unfavorable factors of the prognosis for patients with WDTC are such integrated indicators as the stage of disease IVb and IVc, as well as tumors of the T4b category. It is also unfavorable to recognize the age of patients over 60 years, the presence of distant metastases, the stage of disease IVa, the category of carcinomas T4a and the size of the tumor more than 40 mm. Other prognostic factors (invasion, multifocal tumor growth, metastasis of carcinoma to the lymph nodes, male sex, post-operative relapse), although they are probable predictive factors, but have somewhat less significance in analyzing the prognosis of survival of patients. Conclusion: Understanding the importance of certain prognostic factors of survival is extremely necessary, since they are the only indicators of the effectiveness of the diagnostic, medical and organizational work will reduce the number of patients who require aggressive treatments and, consequently, increase the duration and quality of their postoperative life.

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Natural History of Contralateral Nodules After Lobectomy in Patients With Papillary Thyroid Carcinoma

Abstract: Lobectomy for low-risk patients with a small PTC and nonsuspicious contralateral thyroid nodule(s) is a reliable and safe initial treatment option. In the few patients who required completion thyroidectomy, treatment with surgery and radioiodine was effective.

Cited by 17 publications

References 42 publications

Long-Term Outcome after Hemithyroidectomy for Papillary Thyroid Cancer: A Comparative Study and Review of the Literature

Long-Term Outcome after Hemithyroidectomy for Papillary Thyroid Cancer: A Comparative Study and Review of the Literature

Follow-up of low risk thyroid cancer patients: can we stop follow-up after 5 years of complete remission?

Main Prognostic Factors for Well Differentiated Thyroid Cancer: Analis of Combined Patients Treatment Results during 20 Years after Surgery

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