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Impact of Extent of Surgery on Long-Term Prognosis of Follicular Thyroid Carcinoma Without Extrathyroidal Extension and Distant Metastasis

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Abstract

Aim

To analyze the effect of total thyroidectomy (TT) and thyroid lobectomy (LT) on the long-term prognosis of follicular thyroid carcinoma (FTC) without extrathyroidal extension and distant metastasis and to clarify whether the tumor size (≤ 40 mm vs. > 40 mm) has an important impact on the extent of surgery.

Methods

Data on FTC patients without extrathyroidal extension and distant metastasis treated with either TT or LT between 1998 and 2016 were extracted from the Surveillance, Epidemiology, and End Results Database. Propensity score matching was performed to minimize impact of selection bias and potential confounding. Kaplan–Meier curves and Cox regression analysis were conducted to assess the impact of the extent of surgery on disease-specific survival (DSS).

Results

A total of 8435 patients were identified. The DSS after LT were 100%, 98.3%, and 97.6% at 5, 10, and 15 years, respectively, compared with those seen after TT of 99.3%, 97.9%, and 96.6%. The difference between the two groups is not statistically significant (p = 0.083). Similar results were observed in cohorts after adjusting for baseline covariates. There was also similar prognosis between LT and TT in patients with tumors size ≤ 40 mm or > 40 mm.

Conclusions

For patients with FTC of any size without extrathyroidal extension and distant metastases at diagnosis, TT and LT confer equivalent DSS. Completion thyroidectomy after LT may be not necessary unless patients relapse; however, recurrence rates and development of metastases are not evaluated in this study.

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Data Availability

The data that support the findings of this study are openly available in software package SEER*Stat 8.3.6 (https://seer.cancer.gov/seerstat/).

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Funding

This study was supported by Department of Science and Technology of Sichuan Province (2020YFS0166) and Education Department of Sichuan Province (17ZA0170). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Department of Thyroid and Parathyroid Surgery, Laboratory of thyroid and parathyroid disease, Frontiers Science Center for Disease-related Molecular Network, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China

    Xiaofei Wang, Xun Zheng, Jingqiang Zhu, Zhihui Li & Tao Wei

Authors
  1. Xiaofei Wang
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  2. Xun Zheng
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  3. Jingqiang Zhu
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  4. Zhihui Li
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  5. Tao Wei
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Contributions

J.Z. and T.W. designed the study. X.W. and X.Z. analyzed the data and wrote the paper. J.Z. and Z.L. helped in data collection, data analysis and manuscript writing. All authors reviewed the manuscript and agree to be accountable for all aspects of the work.

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Correspondence to Tao Wei.

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Wang, X., Zheng, X., Zhu, J. et al. Impact of Extent of Surgery on Long-Term Prognosis of Follicular Thyroid Carcinoma Without Extrathyroidal Extension and Distant Metastasis. World J Surg 46, 104–111 (2022). https://doi.org/10.1007/s00268-021-06337-4

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  • DOI: https://doi.org/10.1007/s00268-021-06337-4

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