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Recurrence-free survival after total thyroidectomy and lobectomy in patients with papillary thyroid microcarcinoma

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Abstract

Purpose

The incidence of papillary thyroid microcarcinoma is increasing. We evaluated the recurrence-free survival following total thyroidectomy and lobectomy to identify the optimal surgical choice.

Methods

A meta-analysis was performed using the National Library of Medicine and the National Institutes of Health PubMed database to identify eligible studies. Summary 5- and 10-year RFS estimates after TT versus LT were calculated using random effects models.

Results

The literature search yielded 1117 studies (1990–2019). Nine studies met the inclusion criteria comprising 10,186 total thyroidectomy and 11,408 lobectomy patients. The 5-year recurrence-free survival was 98% [95% confidence interval (CI) 97–99%] after total thyroidectomy and 97% (95% CI 96–99%) after lobectomy, based on eight studies (9421 total thyroidectomy and 11,283 lobectomy patients); the 10-year recurrence-free survival was 95% (95% CI 92–98%) after total thyroidectomy and 92% (95% CI 86–96%) after lobectomy, based on eight studies (total thyroidectomy = 10,100, lobectomy = 11,389 patients).

Conclusion

The present meta-analysis demonstrates excellent, long-term recurrence-free survival following both total thyroidectomy and lobectomy surgery in patients with papillary thyroid microcarcinoma. The analysis also suggests that patients undergoing total thyroidectomy trended toward a slightly better long-term 10-year recurrence-free survival in comparison to patients undergoing lobectomy, a finding of potential, clinical significance in the management decision-making process.

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Availability of data and material

The authors confirm that the data supporting the findings of this study are publicly available without restriction; eligible studies were identified in The National Library of Medicine and the National Institutes of Health PubMed database.

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Acknowledgements

The reported results in this manuscript were presented at the 89th Annual Meeting of the American Thyroid Association (2019).

Funding

This work was partially supported by a private donation.

Author information

Authors and Affiliations

  1. Department of Otolaryngology and Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    M. van Gerwen, M. Alsen, E. Lee, C. Sinclair & E. Genden

  2. Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, P. O. Box 1133, New York, NY, 10029, USA

    M. van Gerwen & E. Taioli

  3. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    E. Taioli

  4. Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    E. Taioli

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  1. M. van Gerwen
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  4. C. Sinclair
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Correspondence to E. Taioli.

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40618_2020_1342_MOESM1_ESM.png

Supplementary file1 Supplementary figure 1: Funnel plot 5-year recurrence free survival- Total thyroidectomy (PNG 32 kb)

Supplementary file2 Supplementary figure 2: Funnel plot 5-year recurrence free survival- Lobectomy (PNG 32 kb)

40618_2020_1342_MOESM3_ESM.png

Supplementary file3 Supplementary figure 3: Funnel plot 10-year recurrence free survival- Total thyroidectomy (PNG 30 kb)

Supplementary file4 Supplementary figure 4: Funnel plot 10-year recurrence free survival- Lobectomy (PNG 32 kb)

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van Gerwen, M., Alsen, M., Lee, E. et al. Recurrence-free survival after total thyroidectomy and lobectomy in patients with papillary thyroid microcarcinoma. J Endocrinol Invest 44, 725–734 (2021). https://doi.org/10.1007/s40618-020-01342-1

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  • DOI: https://doi.org/10.1007/s40618-020-01342-1

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