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- Title
Thyroid Lobectomy for Low-Risk 1–4 CM Papillary Thyroid Cancer is not Associated with Increased Recurrence Rates in the Dutch Population with a Restricted Diagnostic Work-Up.
- Authors
Lin, J. F.; Rodriguez Schaap, P. M.; Metman, M. J. H.; Nieveen van Dijkum, E. J. M.; Dickhoff, C.; Links, T. P.; Kruijff, S.; Engelsman, A. F.
- Abstract
Introduction: The 2015 American Thyroid Association guidelines recommend to de-escalate treatment such as Thyroid lobectomy instead of total thyroidectomy for 1–4 cm papillary thyroid cancer (PTC). Dutch guidelines endorse restricted work-up for thyroid incidentalomas recommending only fine needle aspiration in case of a 'palpable thyroid nodule'. This diagnostic work-up algorithm may result in the identification of less indolent PTCs and may lead to a patient population with relatively more aggressive PTCs. This study aims to retrospectively analyze recurrence rates of low-risk 1–4 cm PTC in the Netherlands. Methods: From the national cancer registry, patients with low-risk 1–4 cm PTC between 2005 and 2015 were included for analysis. Disease free survival (DFS) and overall survival were compared between patients who underwent TT ± RAI and TL without RAI. Post-hoc propensity score analysis was performed correcting for age, sex, T-stage, and N-stage. Results: In total 901 patients were included, of which 711 (78.9%) were females, with a median follow-up of 7.7 years. TT was performed in 893 (94.8%) patients. Recurrence occurred in 23 (2.6%) patients. Multivariable analysis showed no significant correlation between extent of surgery and DFS (p = 0.978), or overall survival (p = 0.590). After propensity score matching, multivariable analysis showed no significant difference on extent of surgery and recurrence. Conclusion: Low-risk PTC patients with 1–4 cm tumor who underwent TL showed similar recurrence rates as those who underwent TT ± adjuvant RAI, which suggests that TL can be sufficient in treating low-risk 1–4 cm PTC, possibly reducing morbidity of these patients in the Netherlands.
- Subjects
NETHERLANDS; HEMITHYROIDECTOMY; THYROIDECTOMY; NEEDLE biopsy; THYROID cancer; PROGRESSION-free survival; PROPENSITY score matching; THYROID nodules
- Publication
World Journal of Surgery, 2023, Vol 47, Issue 5, p1211
- ISSN
0364-2313
- Publication type
Article
- DOI
10.1007/s00268-022-06813-5