[Is the timing of completion thyroidectomy for differentiated thyroid carcinoma prognostic significant?]

The purpose of this study was to evaluate whether the timing of completion thyroidectomy for differentiated thyroid carcinoma had an influence on the risk of the operation and patient's survival. From January 1, 1985 to March 31, 2001, 230 consecutive patients underwent surgery for differentiated thyroid carcinoma (178 papillary and 52 follicular carcinomas). In this article completion thyroidectomy was defined as the removal of the remaining thyroid tissue after any initial surgical procedure less than total thyroidectomy within an interval ranging from 3 days to 4 months after the initial surgical procedure. Of 99.1 % (n = 228) of the 230 patients the postoperative course is known for 1 month to 36 years with a median follow-up of 5 years. Among 81 patients undergoing thyroidectomy as the initial operation, recurrent laryngeal nerve palsy occurred in 13.5 % (n = 11). In 2 of these patients (2.5 %) recurrent laryngeal nerve palsy was permanent. Transient recurrent laryngeal nerve palsy occurred more frequent in patients who underwent completion thyroidectomy within 8 days to 3 months of the initial surgical procedure (20.5 %) than in patients, in whom completion thyroidectomy was performed either within 7 days of the primary operation or after a minimum of 3 months (5.2 % in each group). Disease-free survival as well as long-term survival was not different after thyroidectomy or completion thyroidectomy for all differentiated thyroid carcinomas and in patients with papillary carcinomas. In order to reduce surgical morbidity we suggest that completion thyroidectomy should be performed either within 7 days of the primary operation or after a minimum of 3 months.