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Completion Thyroidectomy Trends and Rates: A Systematic Review and Meta-Analysis
Daniel Soibelman1, Ohad Ronen1,2
1Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
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.
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.
