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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

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Completion Thyroidectomy Trends and Rates: A Systematic Review and Meta-Analysis.

Daniel Soibelman¹, Ohad Ronen^1,2

¹Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.

Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery

|November 26, 2024

Summary

The American Thyroid Association (ATA) 2015 guidelines recommend less aggressive surgery for thyroid cancer. This review found a 17% decrease in completion thyroidectomy rates after the guidelines, indicating wider adoption of conservative approaches.

Keywords:

guidelines meta‐analysis systematic review thyroid carcinoma thyroidectomy

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Area of Science:

Endocrinology
Surgical Oncology
Evidence-Based Medicine

Background:

The 2016 American Thyroid Association (ATA) guidelines updated management for thyroid nodules and well-differentiated thyroid cancers.
A key revision suggested lobectomy as a viable surgical option for low-risk patients.

Purpose of the Study:

To systematically review and compare the rates of completion thyroidectomy before and after the 2015 ATA guidelines publication.
To assess the impact of updated guidelines on surgical management of thyroid cancer.

Main Methods:

A systematic review adhering to PRISMA guidelines.
Searched PubMed and Embase for studies on completion thyroidectomy rates over the past 6 years.
Included 40 studies with over 48,000 patients, analyzing data from before and after the 2015 ATA guidelines.

Main Results:

Completion thyroidectomy rates decreased from 51.8% before 2016 to 43.1% after the 2015 ATA guidelines.
A significant 17% reduction in early completion thyroidectomy surgeries was observed post-guidelines for malignant thyroid pathology.
The findings suggest a shift towards more conservative surgical management.

Conclusions:

Global adoption of the updated ATA guidelines appears to be increasing.
Centers are increasingly favoring conservative surgical approaches compared to the pre-2015 era.
The guidelines have influenced a reduction in completion thyroidectomy rates.