Comparative study of conservative resection and radical operation for thyroid carcinomas

Area of Science:

• Endocrinology
• Surgical Oncology
• Pathology

Background:

• Thyroid cancer management involves surgical intervention, with varying techniques impacting patient outcomes.
• Comparing surgical approaches is crucial for optimizing thyroid cancer treatment protocols.

Purpose of the Study:

• To compare mortality and morbidity between total lobectomy (C-R) and near-total thyroidectomy (R-O) in thyroid cancer patients.
• To correlate pathological subtypes of thyroid cancer with patient prognosis and surgical outcomes.

Main Methods:

• A retrospective study analyzed 44 thyroid cancer patients managed over eleven years at Jos University Teaching Hospital, Nigeria.
• Patients were divided into two groups: total lobectomy (C-R, n=26) and near-total thyroidectomy (R-O, n=18).
• Histopathological analysis of 509 goitrous specimens, including thyroid cancers, was performed. Mortality and morbidity data were collected over a two-year follow-up.

Main Results:

• Total lobectomy (C-R) demonstrated lower mortality (4% vs. 11%) and reduced rates of postoperative hemorrhage (14% vs. 6%), vocal cord paralysis (11% vs. 22%), voice changes (11% vs. 33%), and transitory hypoparathyroidism (8% vs. 50%) compared to near-total thyroidectomy (R-O).
• Local recurrence rates were higher with C-R (18%) versus R-O (11%), while hypothyroidism occurred in all R-O patients.
• Follicular carcinoma (59%) and papillary carcinoma (35%) were the predominant thyroid cancer subtypes.

Conclusions:

• Total lobectomy (C-R) is recommended as the preferred surgical option for thyroid cancer management due to superior outcomes.
• The study highlights the importance of surgical technique selection in minimizing postoperative complications and improving patient prognosis in thyroid cancer.