[Completion thyroidectomy after less than total resection for postoperatively diagnosed follicular thyroid cancer]

Area of Science:

• Endocrinology
• Surgical Oncology
• Pathology

Background:

• Follicular thyroid cancer (FTC) diagnosis lacks reliable preoperative markers.
• Postoperative histopathology often necessitates decisions regarding completion thyroidectomy.
• Assessing the oncological necessity versus morbidity of completion surgery is crucial.

Purpose of the Study:

• To define indications for completion thyroidectomy in follicular thyroid cancer.
• To clarify the role of risk factors and specific tumor characteristics in surgical decision-making.
• To evaluate the safety and necessity of completion thyroidectomy in FTC management.

Main Methods:

• Review of histopathological criteria for FTC.
• Analysis of indications for completion thyroidectomy based on tumor invasion and metastasis.
• Assessment of risk factors including tumor size, age, and angioinvasion.
• Evaluation of prophylactic lymphadenectomy and minimally invasive oncocytic FTC risks.

Main Results:

• Completion surgery is indicated for distant/lymph node metastasis, broadly invasive FTC, or extensive angioinvasion.
• Prophylactic lymphadenectomy is not recommended.
• Minimally invasive oncocytic FTC does not appear to pose a special risk.
• Tumor size and age require individual assessment as continuous risk factors.

Conclusions:

• Completion thyroidectomy decisions for FTC should be based on specific oncological criteria, not assumed morbidity.
• Individualized assessment of risk factors is essential.
• Careful planning and surgical technique allow completion thyroidectomy without increased risk.