Disease control of differentiated thyroid carcinomas by hemithyroidectomy

Area of Science:

• Endocrinology
• Surgical Oncology
• Thyroid Cancer Research

Background:

• Differentiated thyroid carcinoma (DTC) management in Hong Kong predominantly involves total thyroidectomy.
• Hemithyroidectomy presents a less invasive alternative with potentially lower operative morbidity.

Purpose of the Study:

• To investigate the oncological outcomes and surgical morbidity of hemithyroidectomy in selected DTC patients.
• To evaluate the efficacy of hemithyroidectomy as a primary treatment for low-risk DTC.

Main Methods:

• Retrospective analysis of prospectively collected cancer registry data from 236 DTC patients.
• Stratification of patients into risk groups based on age, tumor size, extrathyroid spread, and metastasis.
• Focus on 93 patients treated with hemithyroidectomy, with or without central compartment lymph node dissection, and no postoperative radioactive iodine for low-risk cases.

Main Results:

• A low local tumor recurrence rate of 1.1% (1/93 patients) was observed over a mean follow-up of 63.3 months.
• Surgical morbidity was minimal, with transient vocal cord palsy in 6.5% and permanent palsy in 2.2% of patients.
• No patient mortality was attributed to thyroid cancer.

Conclusions:

• Hemithyroidectomy, particularly when combined with central compartment dissection in select DTC cases, provides excellent tumor control.
• This surgical approach achieves favorable oncological outcomes with significantly minimized surgical morbidity.