Total thyroidectomy and central lymph node dissection. Experience of a referral centre for endocrine surgery

Monacelli, Massimo; Lucchini, Roberta; Polistena, Andrea; Triola, Roberta; Conti, Claudia; Avenia, Stefano; Patrizi, Di; Barillaro, Ivan; Boccolini, Andrea; Sanguinetti, Alessandro; Avenia, Nicola

doi:10.11138/gchir/2014.35.5.117

Cited by 5 publications

(1 citation statement)

References 24 publications

(12 reference statements)

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“…By contrast, Cunningham et al [ 8 ] revealed that the recurrence rates had no significant difference between hemithyroidectomy and total/near-total thyroidectomy groups. Monacelli et al [ 9 ] suggested that total thyroidectomy combined with central node dissection must be performed even in the absence of risk factors and without clinically evident nodes. However, some researchers do not advocate prophylactic central neck lymphadenectomy [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological features of recurrent papillary thyroid cancer

et al. 2015

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BackgroundTo investigate the clinicopathological features of recurrent papillary thyroid carcinoma (PTC).MethodsA retrospective analysis on clinical and pathological data of 34 patients with recurrent PTC was carried out. A total of 281 patients with non-recurrent PTC during the same time period were chosen as the control group.ResultsPatients were divided into three groups according to the pathological subtype. The number of patients belonging to Groups 1, 2, and 3 were 28, 154, and 133, respectively. 78 patients underwent partial or whole thyroidectomy, 151 cases underwent thyroidectomy combining neck regional lymph node dissection, and 86 patients underwent thyroidectomy combining modified or radical neck dissection. Univariate analysis showed that PTC recurrence was associated with tumor size, extrathyroid invasion, initial surgery approach, lymph node metastasis, and pathological subtype (P < 0.05). Patient age, gender, complication with Hashimoto's thyroiditis, and multifocality were unrelated to PTC recurrence (P > 0.05). Multivariate analysis showed that initial surgery approach and pathological subtype perform important functions in PTC recurrence (P < 0.001). Initial surgery approach presented a negative correlation with PTC recurrence (β = −0.320, OR = 0.726). The pathological subtype was also related to PTC recurrence (β = 0.923, OR = 2.517).ConclusionPTC patients without neck dissection showed greater likelihood of postoperative recurrence. Patients with the tall cell, columnar cell, diffuse sclerosing, and oncocytic variants showed a higher propensity for PTC recurrence after operation compared with those who did not. Tumor volume, extrathyroid invasion, and multiple lymph node metastases at the time of initial operation were also significantly related to postoperative recurrence. Follow-up supervision must be enhanced after initial treatment to mitigate PTC recurrence in susceptible patients. Effective and standard treatments must be adopted immediately after the discovery of recurrence.

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Section: Discussionmentioning

confidence: 99%

Clinicopathological features of recurrent papillary thyroid cancer

et al. 2015

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Huge variations in definition and reported incidence of postsurgical hypoparathyroidism: a systematic review

2019

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Is biopsy enough for papillary thyroid microcarcinoma?

Liu

Zhao

Liu³

et al. 2018

Medicine

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The treatment of papillary thyroid microcarcinoma (PTMC) remains deeply controversial. In this study, we investigated the prognosis of patients who underwent biopsy alone, as compared with other forms of thyroidectomy approaches. We sought to provide reference information for treatment selection in cases of PTMC.The analysis included a large cohort of 34,972 PTMC patients from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2013. Survival was examined by Kaplan-Meier analyses with log-rank tests, Cox proportional-hazards regression analyses, and propensity score matching analyses.In the study cohort, the rate of cancer-specific mortality per 1000 person-years was higher for patients who underwent biopsy alone than for those who underwent other surgical approaches. According to multivariate Cox regression analyses, patients undergoing biopsy had similar cancer-specific survival rates and higher all-cause survival rates in comparison with patients undergoing other surgical approaches. After matching for influential factors using propensity scores, Kaplan-Meier analyses also showed that patients undergoing biopsy had similar cancer-specific survival rates and lower all-cause survival rates in comparison with patients undergoing other surgical approaches.Our results provided helpful implications for the treatment of patients with PTMC.

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Total thyroidectomy and central lymph node dissection. Experience of a referral centre for endocrine surgery

Cited by 5 publications

References 24 publications

Clinicopathological features of recurrent papillary thyroid cancer

Clinicopathological features of recurrent papillary thyroid cancer

Huge variations in definition and reported incidence of postsurgical hypoparathyroidism: a systematic review

Is biopsy enough for papillary thyroid microcarcinoma?

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