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The Need for Completion Thyroidectomy in Cases of Differentiated Thyroid Cancer

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

There are no definitive criteria for the presence of malignancy in the opposite lobe in cases of unilateral lobectomy due to a thyroid mass in which the malignancy was diagnosed histologically. Study design is retrospective, cross sectional study. The present study included patients who underwent a lobectomy in our clinic between 2001 and 2016 with an initial diagnosis of atypia with undetermined significance or suspected malignancy according to fine-needle aspiration biopsy and adult patients who received a thyroidectomy based on thyroid cancer detected in pathological examinations. Tumor histopathological diagnosis, tumor size, and capsular, vascular, or lymphatic invasion were assessed in patients who received thyroid lobectomy. The presence of a multifocal tumor (52.3%) significantly increased the risk of malignancy in the opposite lobe over the risk association with a unifocal tumor (8.9%; p < 0001). In patients with a tumor diameter greater than 4 cm (83.3%), the risk of malignancy in the opposite lobe was higher than that in patients with a tumor diameter less than 4 cm (22.3%; p < 0.001). Significant differences were not observed between groups with and without vascular or capsular invasion of the opposite lobe (p = 0.913 and p = 0.840, respectively). We determined risk factors for the presence of multifocal disease in unilateral lobectomy materials; an aggressive tumor subtype and a size larger than 4 cm are the most important factors that increase the risk of malignancy in the opposite lobe.

Level of evidence Level 4—Case–control studies.

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References

  1. Hegedus L (2004) Clinical practice. The thyroid nodule. N Engl J Med. 351:1764–1771

    Article  Google Scholar 

  2. Brito JP, Yarur AJ, Prokop LJ, McIver B, Murad MH, Montori VM (2013) Prevalence of thyroid cancer in multinodular goiter versus single nodule: a systematic review and meta-analysis. Thyroid. 23:449–455

    Article  Google Scholar 

  3. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ et al (2009) Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19:1167–1214

    Article  Google Scholar 

  4. Shaha AR, Jaffe BM (1992) Completion thyroidectomy: a critical appraisal. Surgery 112:1148–1152 (discussion 1152–1153)

    CAS  PubMed  Google Scholar 

  5. Shaha AR (2011) Completion thyroidectomy: fact or fiction? Am J Otolaryngol 32:448–449

    Article  Google Scholar 

  6. Erdem E, Gulcelik MA, Kuru B et al (2003) Comparison of completion thyroidectomy and primary surgery for differentiated thyroid carcinoma. Eur J Surg Oncol 29:747–749

    Article  CAS  Google Scholar 

  7. Rafferty MA, Goldstein DP, Rotstein L et al (2007) Completion thyroidectomy versus total thyroidectomy: is there a difference in complication rates? An analysis of 350 patients. J Am Coll Surg 205:602–607

    Article  Google Scholar 

  8. Gulcelik MA, Kuru B, Dincer H et al (2012) Complicationsof completion versus total thyroidectomy. Asian Pac J Cancer Prev 13:5225–5228

    Article  Google Scholar 

  9. Mishra A, Mishra SK (2002) Total thyroidectomy for differentiated thyroid cancer: primary compared with completion thyroidectomy. Eur J Surg 168:283–287

    Article  Google Scholar 

  10. Udelsman R, Shaha A (2005) Is total thyroidectomy the best possible surgical management for well-differentiated thyroid carcinoma? Lancet Oncol 6:529–531

    Article  Google Scholar 

  11. Wanebo H, Coburn M, Teates D, Cole B (1998) Total thyroidectomy does not enhance disease control or survival even in high-risk patients with differentiated thyroid cancer. Ann Surg 227(6):912–921

    Article  CAS  Google Scholar 

  12. Yoon J, Kwak J, Kim EK, Moon HJ, Kim MJ, Kim JY et al (2010) How to approach thyroid nodules with indeterminate cytology. Ann Surg Oncol 17:2147–2155

    Article  Google Scholar 

  13. Banks ND, Kowalski J, Tsai HL, Somervell H, Tufano R, Dackiw AP et al (2008) Adiagnostic predictor model for indeterminate or suspicious thyroid FNA samples. Thyroid. 18:933–941

    Article  CAS  Google Scholar 

  14. Miller B, Burkey S, Lindberg G et al (2004) Prevalence of malignancy within cytologically indeterminate thyroid nodules. Am J Surg 188:459–462

    Article  Google Scholar 

  15. Goldstein RE, Netterville JL, Burkey B, Johnson JE (2002) Implications of follicular neoplasms, atypia, and lesions suspicious for malignancy diagnosed by fine-needle aspiration of thyroid nodules. Ann Surg 235:656–662 (discussion 662–654)

    Article  Google Scholar 

  16. Castro MR, Espiritu RP, Bahn RS, Henry MR, Gharib H, Caraballo PJ et al (2011) Predictors of malignancy in patients with cytologically suspicious thyroid nodules. Thyroid 21:1191–1198

    Article  Google Scholar 

  17. National Comprehensive Cancer Network (2010) NCCN clinical practice guidelines in oncology. Thyroid carcinoma, vol 1. http://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf. Accessed 1 Jan 201

  18. Cobin RH, Gharib H, Bergman DA, Force Thyroid Carcinoma Task et al (2001) AACE/AAES medical/surgical guidelines for clinical practice: management of thyroid carcinoma. American Association of Clinical Endocrinologists. American college of endocrinology. Endocr Pract 7:202–222

    Article  CAS  Google Scholar 

  19. British Thyroid Association Guidelines for the management of thyroid cancer, 2007; 2nd edn. www.britishthyroidassiciation.org/news/Docs/Thyroid_cancer_guidelines_2007.pdf. Accessed 8 Feb 2012

  20. Takami H, Ito Y, Okamoto T et al (2011) Therapeutic strategy for differentiated thyroid carcinoma in Japan based on a newly established guideline managed by Japanese society of thyroid surgeons and Japanese association of endocrine surgeons. World J Surg 35:111–121. doi:10.1007/s00268-010-0832-6

    Article  PubMed  Google Scholar 

  21. Gharib H, Papini E, Valcavi R, AACE/AME Task Force on Thyroid Nodules et al (2006) American association of clinical endocrinologists and associazione medici endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract 12:63–102

    Article  Google Scholar 

  22. Pacini F, Schlumberger M, Dralle H, Taskforce European Thyroid Cancer et al (2006) European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol 154:787–803

    Article  CAS  Google Scholar 

  23. Sherman SI, Angelos P, Ball DW, National Comprehensive Cancer Network Thyroid Carcinoma Panel et al (2007) Thyroid carcinoma. J Natl Compr Cancer Netw 5:568–621

    Article  Google Scholar 

  24. Matsuzu K, Sugino K, Masudo K, Nagahama M et al (2014) Thyroid lobectomy for papillary thyroid cancer: long-term follow-up study of 1,088 cases. World J Surg 38:68–79

    Article  Google Scholar 

  25. Bilimoria KY, Bentrem DJ, Ko CY et al (2007) Extent of surgery affects survival for papillary thyroid cancer. Ann Surg 246:375–381 (discussion 381–384)

    Article  Google Scholar 

  26. Haigh PI, Urbach DR, Rotstein LE et al (2005) Extent of thyroidectomy is not a major determinant of survival in low- or highrisk papillary thyroid cancer. Ann Surg Oncol 12:81–89

    Article  Google Scholar 

  27. Hay ID, Bergstralh EJ, Goellner JR et al (1993) Predicting outcome in papillary thyroid carcinoma: development of a reliable prognostic scoring system in a cohort of 1,779 patients surgically treated at one institution during 1940 through 1989. Surgery 114:1050–1058

    CAS  PubMed  Google Scholar 

  28. Samaan NA, Maheshwari YK, Nader S et al (1983) Impact of therapy for differentiated carcinoma of the thyroid: an analysis of 706 cases. J Clin Endocrinol Metab 56:1131–1138

    Article  CAS  Google Scholar 

  29. Grant CS, Hay ID, Gough IR et al (1988) Local recurrence in papillary thyroid carcinoma: is extent of surgical resection important? Surgery 104:954–962

    CAS  PubMed  Google Scholar 

  30. Tollefsen H, Shaha J, Huvos A (1972) Papillary carcinoma of the thyroid. Am J Surg 124:468–472

    Article  CAS  Google Scholar 

  31. Cohn KH, Bäckdahl M, Forsslund G et al (1984) Biologic considerations and operative strategy in papillary thyroid carcinoma: arguments against the routine performance of total thyroidectomy. World J Surg 96:957–971

    CAS  Google Scholar 

  32. Rose RG, Kelsy MP, Russel WO et al (1963) Follow-up study of thyroid cancer treated by unilateral lobectomy. Am J Surg 106:494–500

    Article  CAS  Google Scholar 

  33. Mazzaferri EL, Jhiang SM (1994) Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med 97:418–428

    Article  CAS  Google Scholar 

  34. Mazzaferri EL (1999) An overview of the management of papillary and follicular thyroid carcinoma. Thyroid 9:421–427

    Article  CAS  Google Scholar 

  35. Schvartz C, Bonnetain F, Dabakuyo S et al (2012) Impact on overall survival of radioactive iodine in low-risk differentiated thyroid cancer patients. J Clin Endocrinol Metab 97:1526–1535

    Article  CAS  Google Scholar 

  36. Gepalakrishna N, Morris LGT, Tuttle RM et al (2011) Rising incidence of second cancers in patients with low-risk (T1N0) thyroid cancer who receive radioactive iodine therapy. Cancer 117:4439–4446

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Faculty of Medicine, Acibadem University, Istanbul, Turkey

    Bayram Veyseller

  2. Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Blvd. Vatan Street, 34093, Fatih/Istanbul, Turkey

    Alper Yenigun, Fadlullah Aksoy, Aysenur Meric & Orhan Ozturan

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  1. Bayram Veyseller
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  2. Alper Yenigun
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  3. Fadlullah Aksoy
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  4. Aysenur Meric
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Correspondence to Alper Yenigun.

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Veyseller, B., Yenigun, A., Aksoy, F. et al. The Need for Completion Thyroidectomy in Cases of Differentiated Thyroid Cancer. Indian J Otolaryngol Head Neck Surg 71 (Suppl 1), 82–87 (2019). https://doi.org/10.1007/s12070-017-1083-8

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  • DOI: https://doi.org/10.1007/s12070-017-1083-8

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