Annals of Surgical Oncology

, Volume 26, Issue 13, pp 4466–4471 | Cite as

Clinical Significance of Gross Invasion of Strap Muscles in Patients With 1- to 4-cm-Sized Papillary Thyroid Carcinoma Undergoing Lobectomy

  • Eyun SongEmail author
  • Won Woong Kim
  • Min Ji Jeon
  • Tae-Yon Sung
  • Dong Eun Song
  • Tae Yong Kim
  • Ki Wook Chung
  • Won Bae Kim
  • Young Kee Shong
  • Suck Joon Hong
  • Yu-Mi LeeEmail author
  • Won Gu KimEmail author
Head and Neck Oncology



Given the emerging evidence supporting the lack of prognostic significance of gross extrathyroidal extension invading only strap muscles (strap-gETE), this study investigated whether lobectomy is feasible for patients with strap-gETE.


A retrospective cohort study was conducted with 636 patients who had 1- to 4-cm-sized papillary thyroid carcinoma (PTC) treated with thyroid lobectomy. Patients with gross invasion of perithyroidal organs other than strap muscles or synchronous distant metastasis were excluded from the study. Disease-free survival (DFS) was compared according to the presence of strap-gETE.


Strap-gETE was present in 50 patients (7.9%), with the remaining 586 patients (92.1%) showing no evidence of gETE. During the median follow-up period of 7.4 years, 6% of the patients with strap-gETE and 5.1% of the patients without gETE experienced structural persistent/recurrent disease (p = 0.99). No differences in DFS were observed between the two groups (hazard ratio [HR], 1.24; 95% confidence interval [CI], 0.38–4.08; p = 0.720). After adjustment for five major risk factors (age, gender, tumor size, multifocality, and cervical lymph node metastasis status) in the multivariate analysis, the presence of strap-gETE did not exhibit an independent role in the development of structural persistent/recurrent disease (HR 1.05; 95% CI 0.24–4.53, p = 0.950).


Strap-gETE did not increase the risk of structural persistent/recurrent disease for the patients who underwent lobectomy for 1- to 4-cm-sized PTC. The study data support the limited role of strap-gETE in clinical outcomes and may broaden the indications for lobectomy for patients with PTCs.



This study was supported by a Grant (No. 2018-790) from the Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea.

Conflict of interest

There are no conflicts of interest.

Supplementary material

10434_2019_7778_MOESM1_ESM.docx (12 kb)
Supplementary material 1 (DOCX 12 kb)


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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Eyun Song
    • 1
    Email author
  • Won Woong Kim
    • 2
  • Min Ji Jeon
    • 1
  • Tae-Yon Sung
    • 2
  • Dong Eun Song
    • 3
  • Tae Yong Kim
    • 1
  • Ki Wook Chung
    • 2
  • Won Bae Kim
    • 1
  • Young Kee Shong
    • 1
  • Suck Joon Hong
    • 2
  • Yu-Mi Lee
    • 2
    Email author
  • Won Gu Kim
    • 1
    Email author
  1. 1.Division of Endocrinology and Metabolism, Department of Internal MedicineAsan Medical Center, University of Ulsan College of MedicineSeoulRepublic of Korea
  2. 2.Department of SurgeryAsan Medical Center, University of Ulsan College of MedicineSeoulRepublic of Korea
  3. 3.Department of PathologyAsan Medical Center, University of Ulsan College of MedicineSeoulRepublic of Korea

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