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Dynamic risk stratification in patients with follicular thyroid carcinoma treated with lobectomy
Haruhiko Yamazaki1,2, Kiminori Sugino2, Ryohei Katoh3
1Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama City, Kanagawa, Japan.
Background:
Previous studies showed that dynamic risk stratification (DRS) was also useful in differentiated thyroid carcinoma patients with lobectomy or total thyroidectomy without radioactive iodine. The aim of this study was to evaluate the DRS system in patients with follicular thyroid carcinoma (FTC) who underwent lobectomy alone.
Methods:
In total, 161 patients with FTC who were diagnosed between January 2005 and December 2014 and underwent lobectomy alone were included in this study.
Results:
Of the 161 patients with FTC, the DRS system classified 159 patients (99%) as having an excellent response, and 2 (1%) as having a structural-incomplete response. The 10-year disease-free survival (DFS) rates of patients with excellent response and structural-incomplete response were 93.5% and 0%, respectively (P < 0.001). Of the 54 patients with VI ≥ 2, the 10-year DFS rates of patients with excellent response (n = 53) and structural-incomplete response (n = 1) were 83.2% and 0%, respectively (P < 0.001). Of the 53 patients with excellent response, 10 patients experienced disease recurrence. Among Of these ten patients, the duration between initial thyroid surgery and recurrence was 2-5 years in one, 5-8 years in two, 8-10 years in four, and 10 years or more in three patients, respectively.
Conclusion:
Long-term follow-up may be needed in FTC patients treated with lobectomy alone even though they had an excellent response to initial thyroid surgery, especially in patients with a higher risk of recurrence.
