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Oncologic outcomes of robotic thyroidectomy: 5-year experience with propensity score matching

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The oncologic outcome of robotic thyroidectomy is not yet well established. The aim of this study was to evaluate the recurrence rate after robotic thyroidectomy in comparison with conventional thyroidectomy for papillary thyroid carcinoma (PTC).


We analyzed 896 patients with PTC who either underwent robotic (212 patients using a gasless unilateral axillary or an axillo-breast approach) or conventional cervical thyroidectomy (684 patients) with/without central neck dissection between October 2008 and February 2014. We excluded patients who underwent concomitant lateral neck dissection or completion thyroidectomy, and cases with T4 tumor, tumor lager than 4 cm, other types of thyroid cancer, recurrent cancer, and distant metastasis. A propensity score matching analysis was done with ten covariates including age, gender, body mass index, tumor size, multifocality, bilaterality, extrathyroidal extension, type of thyroidectomy, extent of central neck dissection, and RAI ablation to reduce selection bias.


In baseline data, the male ratio and the mean age were lower in the robotic group. Stage, multifocality, and bilaterality were higher in the conventional group. The rate of total thyroidectomy was higher in the conventional group. The two matched groups of each 185 patients were produced and well balanced by propensity score matching. In the comparison of propensity score matched groups, operative time was longer in the robotic group (P < 0.001), and postoperative complications did not differ between the two groups, except for transient hypoparathyroidism and formation of seroma. The recurrence rate did not differ between the two groups after a mean follow-up of 43.6 months (0.5 and 1.1 % in the robotic and conventional groups, respectively, P = 0.375).


The oncologic outcome of robotic thyroidectomy in 5-year experience is comparable to that of conventional thyroidectomy in selected patients with PTC.

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  1. Tae K, Ji YB, Jeong JH, Lee SH, Jeong MA, Park CW (2011) Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach: our early experiences. Surg Endosc 25:221–228

    Article  PubMed  Google Scholar 

  2. Tae K, Ji YB, Cho SH, Kim KR, Kim DW, Kim DS (2011) Initial experience with a gasless unilateral axillo-breast or axillary approach endoscopic thyroidectomy for papillary thyroid microcarcinoma: comparison with conventional open thyroidectomy. Surg Laparosc Endosc Percutan Tech 21:162–169

    Article  PubMed  Google Scholar 

  3. Tae K, Ji YB, Cho SH, Lee SH, Kim DS, Kim TW (2012) Early surgical outcomes of robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach for papillary thyroid carcinoma: 2 years’ experience. Head Neck 34:617–625

    Article  PubMed  Google Scholar 

  4. Tae K, Ji YB, Jeong JH, Kim KR, Choi WH, Ahn YH (2013) Comparative study of robotic versus endoscopic thyroidectomy by a gasless unilateral axillo-breast or axillary approach. Head Neck 35:477–484

    Article  PubMed  Google Scholar 

  5. Kang SW, Lee SC, Lee SH, Lee KY, Jeong JJ, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. Surgery 146:1048–1055

    Article  PubMed  Google Scholar 

  6. Lee J, Kang SW, Jung JJ, Choi UJ, Yun JH, Nam KH, Soh EY, Chung WY (2011) Multicenter study of robotic thyroidectomy: short-term postoperative outcomes and surgeon ergonomic considerations. Ann Surg Oncol 18:2538–2547

    Article  PubMed  Google Scholar 

  7. Kuppersmith RB, Holsinger FC (2011) Robotic thyroid surgery: an initial experience with North American patients. Laryngoscope 121:521–526

    Article  PubMed  Google Scholar 

  8. Lee J, Nah KY, Kim RM, Ahn YH, Soh EY, Chung WY (2010) Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy. Surg Endosc 24:3186–3194

    Article  PubMed  Google Scholar 

  9. Noureldine SI, Jackson NR, Tufano RP, Kandil E (2013) A comparative North American experience of robotic thyroidectomy in a thyroid cancer population. Langenbecks Arch Surg 398:1069–1074

    Article  PubMed  Google Scholar 

  10. Yi O, Yoon JH, Lee YM, Sung TY, Chung KW, Kim TY, Kim WB, Shong YK, Ryu JS, Hong SJ (2013) Technical and oncologic safety of robotic thyroid surgery. Ann Surg Oncol 20:1927–1933

    Article  PubMed  Google Scholar 

  11. Adam MA, Speicher P, Pura J, Dinan MA, Reed SD, Roman SA, Sosa JA (2014) Robotic thyroidectomy for cancer in the US: patterns of use and short-term outcomes. Ann Surg Oncol 21:3859–3864

    Article  PubMed  PubMed Central  Google Scholar 

  12. Lang BH, Wong CK, Tsang JS, Wong KP, Wan KY (2014) A systematic review and meta-analysis comparing surgically-related complications between robotic-assisted thyroidectomy and conventional open thyroidectomy. Ann Surg Oncol 21:850–861

    Article  PubMed  Google Scholar 

  13. Sun GH, Peress L, Pynnonen MA (2014) Systematic review and meta-analysis of robotic vs conventional thyroidectomy approaches for thyroid disease. Otolaryngol Head Neck Surg 150:520–532

    Article  PubMed  Google Scholar 

  14. Wang YC, Liu K, Xiong JJ, Zhu JQ (2015) Robotic thyroidectomy versus conventional open thyroidectomy for differentiated thyroid cancer: meta-analysis. J Laryngol Otol 129:558–567

    Article  PubMed  Google Scholar 

  15. Tae K, Kim KY, Yun BR, Ji YB, Park CW, Kim DS, Kim TW (2012) Functional voice and swallowing outcomes after robotic thyroidectomy by a gasless unilateral axillo-breast approach: comparison with open thyroidectomy. Surg Endosc 26:1871–1877

    Article  PubMed  Google Scholar 

  16. Song CM, Cho YH, Ji YB, Jeong JH, Kim DS, Tae K (2013) Comparison of a gasless unilateral axillo-breast and axillary approach in robotic thyroidectomy. Surg Endosc 27:3769–3775

    Article  PubMed  Google Scholar 

  17. Song CM, Ji YB, Bang HS, Park CW, Kim H, Tae K (2014) Long-term sensory disturbance and discomfort after robotic thyroidectomy. World J Surg 38:1743–1748

    Article  PubMed  Google Scholar 

  18. Ji YB, Song CM, Bang HS, Lee SH, Park YS, Tae K (2014) Long-term cosmetic outcomes after robotic/endoscopic thyroidectomy by a gasless unilateral axillo-breast or axillary approach. J Laparoendosc Adv Surg Tech A 24:248–253

    Article  PubMed  Google Scholar 

  19. Song CM, Ji YB, Bang HS, Park CW, Kim DS, Tae K (2014) Quality of life after robotic thyroidectomy by a gasless unilateral axillary approach. Ann Surg Oncol 21:4188–4194

    Article  PubMed  Google Scholar 

  20. Song CM, Yun BR, Ji YB, Sung ES, Kim KR, Tae K (2016) Long-term voice outcomes after robotic thyroidectomy. World J Surg 40:110–116

    Article  PubMed  Google Scholar 

  21. Tae K, Song CM, Ji YB, Kim KR, Kim JY, Choi YY (2014) Comparison of surgical completeness between robotic total thyroidectomy versus open thyroidectomy. Laryngoscope 124:1042–1047

    Article  PubMed  Google Scholar 

  22. 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 28:1068–1075

    Article  PubMed  Google Scholar 

  23. Lang BH, Wong CK, Tsang JS, Wong KP, Wan KY (2015) A systematic review and meta-analysis evaluating completeness and outcomes of robotic thyroidectomy. Laryngoscope 125:509–518

    Article  PubMed  Google Scholar 

  24. 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 (2009) Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19:1167–1214

    Article  PubMed  Google Scholar 

  25. Perrier ND (2012) Why I have abandoned robot-assisted transaxillary thyroid surgery. Surgery 152:1025–1026

    Article  PubMed  Google Scholar 

  26. Inabnet WB 3rd (2012) Robotic thyroidectomy: must we drive a luxury sedan to arrive at our destination safely? Thyroid 22:988–990

    Article  PubMed  Google Scholar 

  27. Rubin DB, Thomas N (1996) Matching using estimated propensity scores: relating theory to practice. Biometrics 52:249–264

    Article  CAS  PubMed  Google Scholar 

  28. D’Agostino RB Jr (1998) Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med 17:2265–2281

    Article  PubMed  Google Scholar 

  29. Lee SG, Lee J, Kim MJ, Choi JB, Kim TH, Ban EJ, Lee CR, Kang SW, Jeong JJ, Nam KH, Jo YS, Chung WY (2015) Long-term oncologic outcome of robotic versus open total thyroidectomy in PTC: a case-matched retrospective study. Surg Endosc. doi:10.1007/s00464-015-4632-9

    PubMed Central  Google Scholar 

  30. Tae K, Ji YB, Song CM, Min HJ, Lee SH, Kim DS (2014) Robotic lateral neck dissection by a gasless unilateral axillobreast approach for differentiated thyroid carcinoma: our early experience. Surg Laparosc Endosc Percutan Tech 24:e128–e132

    Article  PubMed  Google Scholar 

  31. Randolph GW, Duh QY, Heller KS, LiVolsi VA, Mandel SJ, Steward DL, Tufano RP, Tuttle RM (2012) The prognostic significance of nodal metastases from papillary thyroid carcinoma can be stratified based on the size and number of metastatic lymph nodes, as well as the presence of extranodal extension. Thyroid 22:1144–1152

    Article  PubMed  Google Scholar 

  32. Mazzaferri EL, Kloos RT (2001) Clinical review 128: current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab 86:1447–1463

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Kyung Tae.

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Drs. Kyung Tae, Chang Myeon Song, Yong Bae Ji, Eui Suk Sung, Jin Hyeok Jeong, and Dong Sun Kim have no conflicts of interest or financial ties to disclose.

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Tae, K., Song, C.M., Ji, Y.B. et al. Oncologic outcomes of robotic thyroidectomy: 5-year experience with propensity score matching. Surg Endosc 30, 4785–4792 (2016).

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