Related Experiment Video
Updated: Aug 19, 2026
Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
The T Stage of Papillary Thyroid Cancer and Its Effect on Regional Complications of Thyroidectomy
Fahad Rind1, Songzhu Zhao2, Stephen Kang1,2
1Division of Head and Neck Oncology Ohio State University Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute Columbus Ohio USA.
Objectives:
To evaluate the impact of increasing AJCC T stage on postoperative morbidity in patients undergoing thyroidectomy for papillary thyroid cancer.
Study Design:
Retrospective cross-sectional database study.
Setting:
The American College of Surgeons National Surgical Quality Improvement Program (NSQIP), which collects surgical outcomes data from ~700 US hospitals.
Methods:
NSQIP Participant User Files were queried for thyroidectomy procedures (CPT codes 60210, 60212, 60220, 60225, 60240, 60252, 60254, 60260) from 2016 to 2020 with a pathology-confirmed diagnosis of papillary thyroid cancer. Primary exposure was T stage and outcomes included hoarseness, hypocalcemia, and hematoma formation. Multivariate analysis controlled for N stage, total thyroidectomy, multifocality, and neck dissection.
Results:
A total of 10,901 cases were identified (74.2% female; mean age 50.1 ± 15.1 years). Compared to early-stage tumors, T3 cancers were associated with increased risk of hoarseness (OR 1.614, 95% CI 1.260-2.074, P < .01) and 30-day hypocalcemia (OR 1.296, 95% CI 1.022-1.645, P = .03). Upstaging to T4 further increased risks of hoarseness (OR 2.971, 95% CI 2.039-4.282, P < .01), hematoma (OR 2.266, 95% CI 1.027-4.999, P = .04), and hypocalcemia (OR 1.542, 95% CI 1.007-2.364, P < .05). No significant morbidity difference was observed between T1 and T2 tumors.
Conclusion:
Increasing T stage is associated with significantly higher postoperative morbidity in patients with papillary thyroid cancer, particularly when advancing to T3 or T4. These findings highlight the importance of preoperative risk assessment and surgical planning in advanced disease.
