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The Ongoing Debate Regarding Completion Thyroidectomy Versus Primary Thyroid Surgery for Low and Intermediate
Hyder Mirghani1, Ibrahim A Altedlawi Albalawi2
1Medicine, University of Tabuk, Tabuk, SAU.
Cureus
|December 17, 2020
Summary
For differentiated thyroid cancer (DTC), completion thyroidectomy after lobectomy showed no increased complications compared to initial surgery. Further research is needed to clarify optimal surgical strategies for thyroid cancer.
Area of Science:
- Endocrinology
- Surgical Oncology
- Oncology
Background:
- Lobectomy is common for low-risk differentiated thyroid cancer (DTC) and papillary thyroid microcarcinoma (PTMC).
- Controversy exists regarding the necessity of completion thyroidectomy (CT) after initial lobectomy for these conditions.
Purpose of the Study:
- To compare the outcomes of initial surgical procedures versus completion thyroidectomy (CT) for low/intermediate-risk thyroid carcinoma.
- To assess post-surgery complications associated with lobectomy versus completion thyroidectomy.
Main Methods:
- A meta-analysis of 15 studies involving 17,143 patients was conducted.
- Included studies comprised retrospective, prospective, and controlled trial designs from various global regions.
- Initial search yielded 661 articles, with 15 selected based on inclusion/exclusion criteria.
Main Results:
- No significant difference in post-surgery complications was observed between lobectomy and primary thyroid surgery.
- Completion thyroidectomy (CT) demonstrated similar complication rates to the initial surgical procedure for differentiated thyroid cancer (DTC).
Conclusions:
- Current evidence suggests completion thyroidectomy does not increase complications for differentiated thyroid cancer (DTC) compared to initial surgery.
- Limitations include the predominance of retrospective studies, non-uniform outcome assessment, and significant heterogeneity.
- Further well-controlled, specific trials are required to definitively guide surgical management.
