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Partial thyroidectomy for papillary thyroid microcarcinoma: Is completion total thyroidectomy indicated?
C Dobrinja1, M Pastoricchio1, M Troian1
1Division of General Surgery, Department of Medical, Surgical and Health Sciences, Cattinara Teaching Hospital, Strada di Fiume, 34149, Trieste, Italy.
International Journal of Surgery (London, England)
|May 17, 2017
Summary
For papillary thyroid microcarcinoma (PTMC), hemithyroidectomy (HT) may be suitable for low-risk cases, while total thyroidectomy (TT) is also effective. Careful patient selection is crucial for optimal surgical management of PTMC.
Area of Science:
- Endocrinology
- Surgical Oncology
- Thyroid Cancer Research
Background:
- Papillary thyroid microcarcinoma (PTMC) incidence is rising globally.
- Surgical management options for PTMC, including hemithyroidectomy (HT) and total thyroidectomy (TT), are debated.
- Completion thyroidectomy (CT) is sometimes performed after initial HT for PTMC.
Purpose of the Study:
- To evaluate surgical outcomes for PTMC.
- To compare hemithyroidectomy (HT) versus total thyroidectomy (TT) for PTMC.
- To identify optimal surgical strategies for PTMC based on patient risk stratification.
Main Methods:
- Retrospective analysis of patients diagnosed with PTMC between 2001 and 2016.
- Patients categorized into total thyroidectomy (TT) or hemithyroidectomy (HT) groups.
- Analysis of clinical and histopathological parameters, including recurrence rates and complications.
Main Results:
- Total thyroidectomy (TT) group (86 patients) had a 1.2% recurrence rate.
- Hemithyroidectomy (HT) group (19 patients) showed an 8.4% reoperation rate (CT or contralateral lobe surgery).
- Multifocality was observed in 22% of TT patients and 5.3% of HT patients.
Conclusions:
- Low-risk PTMC patients may benefit from conservative hemithyroidectomy (HT) with close follow-up.
- Patient selection based on risk stratification is essential for tailoring PTMC surgical treatment.
- Both HT and TT are effective, but individualized approaches improve outcomes.
