Total thyroidectomy versus thyroid lobectomy for papillary thyroid cancer: Comparative analysis after propensity...

Area of Science:

• Endocrinology
• Surgical Oncology
• Oncology

Background:

• The surgical management of papillary thyroid carcinoma (PTC) remains a subject of debate, specifically concerning the extent of thyroid resection.
• Total thyroidectomy (TT) and thyroid lobectomy (TL) are the primary surgical options for PTC.

Purpose of the Study:

• To compare the oncologic outcomes and adverse events between TT and TL in patients with 1- to 5-cm stage cN0 and cM0 PTC.
• To determine if the extent of surgical resection impacts recurrence-free survival (RFS) and overall survival (OS).

Main Methods:

• A retrospective study evaluated 173 patients with PTC who underwent curative surgery between 1994 and 2008.
• Propensity score matching was used to adjust for baseline clinicopathologic differences between TT and TL groups.
• Recurrence-free survival (RFS) and overall survival (OS) were compared between the groups.

Main Results:

• Patients undergoing TT were older and had larger tumors with more frequent nodal metastasis, multifocal disease, and extracapsular invasion.
• Adverse events, including hypocalcemia and recurrent laryngeal nerve paralysis, were more frequent after TT than TL.
• After propensity score matching, no significant differences in 10-year RFS (90.6% vs 93.0%) or OS (96.2% vs 96.9%) were observed between TT and TL groups.

Conclusions:

• For 1- to 5-cm stage cN0 and cM0 PTC, both TL and TT provide equivalent prognoses.
• Thyroid lobectomy (TL) is associated with a lower incidence of adverse events compared to total thyroidectomy (TT).
• These findings support considering TL as a viable surgical option for select PTC patients.