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Does Tumor Size Affect Surgical Outcomes of Transoral Robotic Thyroidectomy for Patients with Papillary Thyroid Carcinoma? A Retrospective Cohort Study

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Transoral robotic thyroidectomy (TORT) for differentiated thyroid carcinoma is increasing in popularity. However, studies are limited to small tumors. This study aimed to compare the outcomes of TORT for papillary thyroid carcinomas smaller than 1 cm and 1 cm or larger.

Methods

The study analyzed 269 patients with papillary thyroid carcinoma who underwent TORT at Korea University Hospital, Korea between January 2001 and December 2017. Surgical outcomes and postoperative complications were compared.

Results

Group 1 (tumor < 1 cm) had 215 patients, and group 2 (tumor ≥ 1 cm) had 54 patients. The majority of the patients underwent lobectomy (95.8% in group 1 and 87.0% in group 2; p = 0.339) and unilateral central neck dissection (96.3% in group 1 and 88.9% in group 2; p = 0.024). The two groups did not differ significantly in terms of gender, age, body mass index, thyroiditis status, Da Vinci model. or operative procedure. The majority of the tumors in group 1 (73%) had T1a staging, whereas the majority of the tumors in group 2 were stage T1b or T3a (44.4% in each group; p = 0.000). Most of the patients in group 1 had N0 staging (59.1%), whereas most of the patients in group 2 had N1a staging (55.6%; p = 0.026). The mean operative time was significantly longer in group 2 (198.0 ± 34.2 min in group 1 vs. 215.7 ± 49.3 min in group 2; p = 0.015). The two groups did not differ significantly regarding length of stay, postoperative pain score, or thyroglobulin level. No patients experienced locoregional or distant recurrence. No statistically significant difference in overall complications was observed (p = 0.214).

Conclusions

Transoral robotic thyroidectomy is a safe and effective procedure and may be a feasible option for patients with papillary thyroid carcinomas larger than 1 cm.

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Authors and Affiliations

  1. Department of Surgery, Queen Elizabeth Hospital, Kowloon, Hong Kong, Jordan

    Dora K. C. Tai MD

  2. Department of Surgery, Korea University Thyroid Center, Korea University College of Medicine, Seongbuk-gu, Seoul, Republic of Korea

    Hoon Yub Kim MD, PhD, FACS & Dawon Park MD

  3. Division of Endocrine and Oncologic Surgery, Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA

    Hoon Yub Kim MD, PhD, FACS & Emad Kandil MD, MBA, FACS

  4. Department of Otolaryngology–Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Jonathon O. Russell MD, FACS & Ralph P. Tufano MD, MBA, FACS

Authors
  1. Dora K. C. Tai MD
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  2. Hoon Yub Kim MD, PhD, FACS
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  3. Dawon Park MD
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  4. Jonathon O. Russell MD, FACS
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  5. Ralph P. Tufano MD, MBA, FACS
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  6. Emad Kandil MD, MBA, FACS
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Corresponding author

Correspondence to Hoon Yub Kim MD, PhD, FACS.

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Tai, D.K.C., Kim, H.Y., Park, D. et al. Does Tumor Size Affect Surgical Outcomes of Transoral Robotic Thyroidectomy for Patients with Papillary Thyroid Carcinoma? A Retrospective Cohort Study. Ann Surg Oncol 27, 3842–3848 (2020). https://doi.org/10.1245/s10434-020-08429-2

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  • DOI: https://doi.org/10.1245/s10434-020-08429-2

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