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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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Total versus hemithyroidectomy for small unilateral papillary thyroid carcinoma
Dania Hirsch1, Sigal Levy2, Gloria Tsvetov1
1Institute of Endocrinology, Rabin Medical Center, Beilinson Hospital, Petach Tikva 49100, Israel ; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Oncology Letters
|February 13, 2014
Summary
For low-risk papillary thyroid cancer (PTC), hemithyroidectomy leads to more follow-up procedures and reoperations without clear patient benefit compared to total thyroidectomy.
Area of Science:
- Endocrinology
- Surgical Oncology
- Thyroid Cancer Research
Background:
- The optimal surgical management for low-risk, intrathyroidal papillary thyroid carcinoma (PTC) remains debated.
- Unilateral thyroidectomy is proposed to reduce perioperative morbidity.
Purpose of the Study:
- To evaluate the effectiveness of hemithyroidectomy versus total thyroidectomy for small, unilateral papillary thyroid carcinoma.
- To compare patient outcomes and follow-up requirements between the two surgical approaches.
Main Methods:
- Retrospective comparative analysis of 161 patients with PTC treated between 2001-2010.
- Inclusion criteria: preoperatively predicted localized unilateral disease.
- Groups: 60 hemithyroidectomy patients and 101 total thyroidectomy patients.
Main Results:
- No significant difference in permanent surgical complications between groups.
- Hemithyroidectomy group showed increased referrals for neck ultrasound and fine needle aspirations (FNAs).
- Higher rate of reoperation for suspected recurrent/persistent disease in the hemithyroidectomy group (P=0.06).
Conclusions:
- Hemithyroidectomy for small unilateral PTC is associated with a substantial follow-up burden.
- This approach offers no discernible patient benefit over total thyroidectomy.
- Further research into optimal surgical strategies for early-stage thyroid cancer is warranted.
