Outcomes after completion thyroidectomy versus total thyroidectomy for differentiated thyroid cancer: A single-center...

Area of Science:

• Endocrinology
• Surgical Oncology
• Head and Neck Surgery

Background:

• Thyroid cancer diagnosis often follows diagnostic thyroid lobectomy.
• Completion thyroidectomy (CT) may be necessary for intermediate or high-risk tumors.
• The safety and completeness of CT versus total thyroidectomy (TT) require evaluation.

Purpose of the Study:

• To compare the completeness of resection between TT and CT.
• To assess the complication rates associated with TT and CT.

Main Methods:

• Retrospective review of patients undergoing TT or CT (2000-2018).
• Comparison of pathology, unstimulated thyroglobulin (uTg), parathyroid hormone (PTH) levels, and rates of hematoma and recurrent laryngeal nerve (RLN) injury.

Main Results:

• No significant difference in postoperative uTg at 6 months between TT and CT (0.2 ng/mL).
• Transient hypoparathyroidism was more common after TT (14.3%) than CT (6.0%).
• No differences observed in postoperative hematoma, transient RLN injury, permanent hypoparathyroidism, or permanent RLN injury.

Conclusions:

• CT can achieve complete resection in differentiated thyroid cancer (DTC), as indicated by postoperative uTg levels.
• CT is associated with a lower incidence of transient hypoparathyroidism compared to TT.
• CT does not increase the risk of hematoma, RLN injury, or permanent hypoparathyroidism.