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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
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Predictive Factors for Occult Bilateral Papillary Thyroid Carcinoma
1Department of Ultrasonography, Beijing Friendship Hospital, Capital Medical University, 95 Yong an Street, Xicheng District, Beijing, China.
Academic Radiology
|April 8, 2020
Summary
Occult bilateral papillary thyroid carcinoma (PTC) affects 11.95% of patients. Vascularity and lymph node metastasis on ultrasound are key predictors, suggesting caution with total thyroidectomy for unilateral PTC.
Area of Science:
- Endocrinology
- Oncology
- Surgical Pathology
Background:
- Bilateral papillary thyroid carcinoma (PTC) often necessitates aggressive treatment like total thyroidectomy (TT).
- Preoperative diagnosis of unilateral PTC presents a challenge in determining the extent of surgery due to potential undetected contralateral foci.
- Investigating occult bilateral PTC is crucial for optimizing surgical strategies.
Purpose of the Study:
- To determine the prevalence of occult bilateral PTC in patients initially diagnosed with unilateral PTC.
- To identify predictive factors for the presence of occult PTC in the contralateral lobe.
Main Methods:
- Retrospective analysis of 586 patients with unilateral PTC diagnosed preoperatively by ultrasound.
- Patients underwent total thyroidectomy and cervical lymph node dissection.
- Statistical analyses including Student's t test, chi-squared test, and multivariate analysis were used to identify risk factors.
Main Results:
- Occult bilateral PTC was identified in 70 out of 586 patients (11.95%).
- Multivariate analysis revealed vascularity (OR: 2.180) and ultrasound diagnosis of lymph node metastasis (USLNM) (OR: 2.056) as independent predictors of occult bilateral PTC.
- These factors significantly increased the likelihood of malignancy in the contralateral lobe.
Conclusions:
- The prevalence of occult contralateral PTC is 11.95%.
- Vascularity and USLNM are significant risk factors for bilateral PTC.
- Caution is advised when performing total thyroidectomy in patients with preoperative risk factors for PTC, particularly those with an isolated focus.
