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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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Completion thyroidectomy: predicting bilateral disease.

Badr Ibrahim1, Véronique-Isabelle Forest2,3, Michael Hier4,5

  • 1Division of Otolaryngology Head and Neck Surgery, McGill Thyroid Cancer Center, Jewish General Hospital, 3755 Cote Ste Catherine, Montreal, H3T 1E2, QC, Canada. ibra.badr@gmail.com.

Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'Oto-Rhino-Laryngologie Et De Chirurgie Cervico-Faciale
|June 17, 2015
PubMed
Summary
This summary is machine-generated.

Nearly half of patients with thyroid cancer found in one lobe require completion thyroidectomy due to malignancy in the other lobe. Multifocal tumors in the initial specimen predict contralateral disease, aiding surgical decisions.

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Pathology

Background:

  • Diagnostic hemithyroidectomy is common for indeterminate thyroid nodules.
  • Malignancy confirmation necessitates counseling on completion thyroidectomy.

Purpose of the Study:

  • Determine the incidence of well-differentiated thyroid cancer (WDTC) in the contralateral lobe post-hemithyroidectomy.
  • Identify initial tumor features predicting contralateral WDTC.

Main Methods:

  • Retrospective review of 97 patients undergoing hemithyroidectomy and completion thyroidectomy (2006-2012).
  • Analysis of pathology reports and patient/nodule characteristics.

Main Results:

  • 48% of patients had contralateral lobe malignancy.
  • Papillary microcarcinomas (PMCs) comprised 89% of contralateral malignancies.
  • Multifocal initial tumors predicted contralateral malignancy (60% rate, OR=2.74-3.59).

Conclusions:

  • Contralateral lobe malignancy occurs in 48% of cases.
  • Multifocality and aggressive subtypes in initial specimens are key factors for completion thyroidectomy decisions.
  • Tumor size alone is less predictive than multifocality.