Long-term oncologic outcome of robotic versus open total thyroidectomy in PTC: a case-matched retrospective study
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The role of the robot in thyroid surgery remains uncertain, and it is unclear whether robotic total thyroidectomy (R-TT) can be justified as a standard treatment for patients with thyroid cancer. This study compared the long-term operative results and oncologic outcomes of R-TT and conventional open TT (O-TT) after propensity score matching of the cohorts.
This study retrospectively evaluated patients with papillary thyroid cancer (PTC) who underwent TT with central compartment node dissection (CCND) by a single surgeon in tertiary medical center. Of the 833 patients, 94 (11.3 %) were lost to follow-up. 245 (33.2 %) underwent R-TT, and 494 (66.8 %) underwent O-TT. The mean follow-up duration was 74 (range 61–91) months. Propensity score matching in age, gender, tumor size, extrathyroidal invasion, multiplicity, bilaterality, and TNM stage identified 206 pairs of patients. The long-term oncologic outcomes were assessed in the R-TT and O-TT groups before and after adjustment for baseline covariates.
After adjustment for baseline covariates, serum thyroglobulin (Tg) (p = 0.746) and anti-thyroglobulin antibody (TgAb) (p = 0.394) concentrations were similar in the two groups 5 years after surgery. Nine patients experienced locoregional recurrence, six in the O-TT and three in the R-TT group, with all recurrences in regional LNs. Disease-free survival (DFS) was similar in the R-TT and O-TT groups before matching (p = 0.890) and after adjustment for baseline covariates (p = 0.882).
This represents the first report of 5-year surgical outcomes in patients who underwent R-TT for thyroid cancer. Long-term oncologic quality was similar after R-TT and O-TT.
KeywordsRobotic thyroidectomy Long-term oncologic outcome Disease-free survival Case-matched study Papillary thyroid cancer
Compliance with ethical standards
Jandee Lee received grant supported from National Research Foundation of Korea (NRF) grants funded by the Korean government (MEST) (2014R1A1A2059343). Woong Youn Chung received grant support from a Faculty Research Grant from Yonsei University College of Medicine (6-2015-0056). Woong Youn Chung and Jandee Lee received Grant support from Intuitive Surgical Clinical Robotics Research Grant. Seul Gi Lee, Min Jhi Kim, Jung Bum Choi, Tae Hyung Kim, Eun Jeong Ban, Cho Rok Lee, Sang Wook Kang, Jong Ju Jeong, Kee Hyun Nam, Young Suk Jo have no conflicts of interest or financial ties to disclose.
- 1.Huscher CSG, Chiodini S, Napolitano C, Recher A (1997) Endoscopic right thyroid lobectomy. Surg Endosc Ultrasound Interv Tech 11(8):877Google Scholar
- 13.Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Pacini F, Schlumberger M, Sherman SI, Steward DL, Tuttle RM (2010) Revised American thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer (vol 20, pg 674, 2010). Thyroid 20(8):942CrossRefGoogle Scholar
- 20.Lee S, Lee CR, Lee SC, Park S, Kim HY, Son H, Kang SW, Jeong JJ, Nam KH, Chung WY, Park CS, Cho A (2014) Surgical completeness of robotic thyroidectomy: a prospective comparison with conventional open thyroidectomy in papillary thyroid carcinoma patients. Surg Endosc 28(4):1068–1075CrossRefPubMedGoogle Scholar