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Isthmusectomy in selected patients with well-differentiated thyroid carcinoma
Hakyoung Park1,2, Victoria Harries1, Marlena R McGill1
1Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Head & Neck
|October 8, 2019
Summary
Isthmusectomy alone is a viable surgical option for select well-differentiated thyroid carcinoma (WDTC) cases. This approach demonstrates excellent disease-specific survival and recurrence-free survival in low- and intermediate-risk patients.
Area of Science:
- Endocrinology
- Surgical Oncology
- Thyroid Cancer Research
Background:
- The role of isthmusectomy in treating well-differentiated thyroid carcinoma (WDTC) remains a subject of debate.
- This study evaluates the efficacy of isthmusectomy as a standalone treatment for WDTC.
Purpose of the Study:
- To assess the outcomes of WDTC patients treated exclusively with isthmusectomy.
- To determine the disease-specific survival (DSS) and recurrence-free survival (RFS) rates for this patient cohort.
Main Methods:
- Retrospective analysis of 43 WDTC patients who underwent isthmusectomy alone.
- Kaplan-Meier method used to calculate DSS and RFS.
- Analysis of patient and tumor characteristics, including pT classification and American Thyroid Association risk stratification.
Main Results:
- Most patients had pT1 classification (41/43), with 10 patients having pN1a status.
- 9 patients were classified as low-risk and 22 as intermediate-risk.
- 5- and 10-year DSS was 100%, and 5- and 10-year RFS was 93.1%, with one local recurrence and two regional metastases.
Conclusions:
- Isthmusectomy alone can be considered an acceptable surgical procedure for carefully selected WDTC patients.
- This approach is suitable for low- and intermediate-risk WDTC cases confined to the thyroid isthmus.
