Comparison between total thyroidectomy and hemithyroidectomy in TIR3B thyroid nodules management

Area of Science:

• Endocrinology
• Surgical Oncology
• Pathology

Background:

• Thyroid nodules classified as TIR3B present a diagnostic challenge due to their potential for malignancy.
• Accurate risk stratification and appropriate surgical management are crucial for optimal patient outcomes.

Purpose of the Study:

• To compare the efficacy and safety of total thyroidectomy (TT) versus hemithyroidectomy (HT) in managing TIR3B thyroid nodules.
• To evaluate the rates of malignancy and post-surgical complications associated with each surgical approach.

Main Methods:

• A retrospective analysis of 136 patients diagnosed with TIR3B thyroid nodules between 2011 and 2019.
• Patients underwent either TT (106 cases) or HT (30 cases).
• Outcomes assessed included final histopathological diagnosis, malignancy rates, and post-surgical complications.

Main Results:

• A high malignancy rate of 48% was observed in the TIR3B cohort.
• Malignancy was significantly more frequent in the TT group (53%) compared to the HT group (30%) (p=0.001).
• Both TT and HT demonstrated low rates of post-surgical complications, with one case of transient hypocalcemia reported after TT.

Conclusions:

• The observed malignancy rate for TIR3B lesions is higher than anticipated.
• Both TT and HT are effective surgical options for TIR3B nodules, offering low complication rates.
• Decision-making for surgical approach should integrate clinical risk factors, nodule characteristics, patient preferences, and surgeon expertise.