Completion thyroidectomy may not be required for papillary thyroid carcinoma with multifocality, lymphovascular invasion, extrathyroidal extension to the strap muscles, or five or more central lymph node micrometastasis

医学 淋巴血管侵犯 微转移 甲状腺癌 病态的 淋巴结 甲状腺切除术 甲状腺 内科学 胃肠病学 外科 癌症 转移
作者
Da Beom Heo,Yudan Piao,Ju Hee Lee,Sang-Hyeon Ju,Hyon‐Seung Yi,Minsu Kim,Ho-Ryun Won,Jae Won Chang,Bon Seok Koo,Yea Eun Kang
出处
期刊:Oral Oncology [Elsevier BV]
卷期号:134: 106115-106115 被引量:8
标识
DOI:10.1016/j.oraloncology.2022.106115
摘要

This study aimed to determine whether completion thyroidectomy is necessary based on long-term follow-up oncological results according to various clinical and pathological characteristics of patients with papillary thyroid carcinoma (PTC) who underwent lobectomy.We enrolled 1815 patients with PTC who underwent thyroid lobectomy from January 2003 to December 2014. Various clinical and pathological characteristics were reviewed retrospectively, and clinicopathologic characteristics and recurrence rates were analyzed.Eighty-two (4.5%) patients showed locoregional recurrence during the average 10.2-year follow-up period. There was no significant difference in tumor size, multifocality, lymphovascular invasion (LVI), microscopic or strap muscle-extrathyroidal extension, and central neck lymph node (LN) micrometastasis between the recurrence and non-recurrence groups. The gross strap muscle-extrathyroidal extension group was associated with older age (p < 0.001), larger tumor size (p < 0.001), more capsular invasion (p < 0.001), and more LVI (p < 0.001) than the negative extrathyroidal extension group; there was no significant difference in recurrence between the groups (p = 0.096). Patients with five or more central LN micrometastases were associated with younger age (p = 0.006), larger tumor size (p = 0.04), and presence of LVI (p = 0.033) than patients with less than five central LN metastases; there was no significant difference in recurrence between the groups (p = 0.867). All patients with recurrence were cured through reoperation after recurrence was confirmed.After thyroid lobectomy, PTC patients with multifocality, LVI, extrathyroidal extension to the strap muscles, or five or more central LN micrometastases may not require immediate completion thyroidectomy.
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