Long-Term Outcomes of Total Thyroidectomy Versus Thyroid Lobectomy for Papillary Thyroid Microcarcinoma: Comparative Analysis After Propensity Score Matching

Thyroid ◽  
2013 ◽  
Vol 23 (11) ◽  
pp. 1408-1415 ◽  
Author(s):  
Jandee Lee ◽  
Jae Hyun Park ◽  
Cho-Rok Lee ◽  
Woong Youn Chung ◽  
Cheong Soo Park
Keyword(s):  
Comparative Analysis ◽  
Propensity Score ◽  
Total Thyroidectomy ◽  
Propensity Score Matching ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Long Term Outcomes ◽  
Thyroid Microcarcinoma ◽  
Thyroid Lobectomy

scholarly journals Long-term Outcomes and Prognostic Factors in Papillary Thyroid Microcarcinoma Patients with Distant Metastases

2021 ◽  
Author(s):  
Huai-Yu Weng ◽  
Ting Yan ◽  
Wang-Wang Qiu ◽  
Chuang Xi ◽  
Li-Ying Hou ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Radioactive Iodine ◽  
Distant Metastases ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Long Term Outcomes ◽  
Thyroid Microcarcinoma ◽  
Male Sex

Abstract PurposesDistant metastasis from papillary thyroid microcarcinoma (PTMC) is extremely rare and the long-term outcome and independent prognostic factors remain unclear.The present study aimed to investigate clinicopathological characteristics and evaluate the long-term outcomes and prognostic factors of PTMC patients with distant metastases (DM) who underwent surgery and radioactive iodine (131I) treatment.MethodsWe retrospectively reviewed the medical records of 13,441 patients with thyroid cancer (including 1,697 cases with PTMC) who underwent 131I treatment at our institution between January 2008 and December 2019. PTMC patients with distant metastases with sufficient clinical follow-up data were enrolled in this cohort study. The overall survival (OS) and progression-free survival (PFS) were analyzed by the Kaplan–Meier method and the prognostic factors were assessed by Cox proportional hazards. ResultsThirty-three PTMC patients with DM were enrolled in this study. The median follow-up was 75 months (range: 5–151 months).The 5-year and 10-year OS rates were 96.97% and 81.41%, respectively, and the 5-year and 10-year PFS rates were 90.46% and 69.68%, respectively. Multivariate analysis showed that male sex(P=0.005) , radioactive iodine refractory PTMC (P=0.033) and symptomatic DM (P=0.022) were significantly associated with worse 10-year PFS in PTMC patients with DM. No independent predictor related to poor 10-year OS found in the present study.ConclusionsThe prognosis of PTMC patients becomes worse after the development of DM. Male sex, radioactive iodine refractory PTMC and symptomatic DM were identified as independent factors associated with PFS.

scholarly journals Extent of Surgery and the Prognosis of Unilateral Papillary Thyroid Microcarcinoma

2021 ◽  
Vol 12 ◽  
Author(s):  
Hengqiang Zhao ◽  
Le Cui
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Distant Metastasis ◽  
Cox Regression ◽  
Extrathyroidal Extension ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Thyroid Microcarcinoma ◽  
Kaplan Meier ◽  
Extent Of Surgery

It remains controversial whether patients with papillary thyroid microcarcinoma (PTMC) benefit from total thyroidectomy (TT) or thyroid lobectomy (TL). We aimed to investigate the impact of extent of surgery on the prognosis of patients with unilateral PTMC. Patients were obtained from the Surveillance, Epidemiology, and End Results database from 2004 to 2015. Cancer-specific survival (CSS) and overall survival (OS) were evaluated by Cox regression and Kaplan–Meier curves with propensity score matching. Of 31167 PTMC patients enrolled, 22.2% and 77.8% of which underwent TL and TT, respectively. Patients with TT were more likely to be younger, females, present tumors of multifocality, extrathyroidal extension, cervical lymph node metastasis (CLNM), distant metastasis, and receive radioactive iodine (RAI) compared with those receiving TL. The multivariate Cox regression model showed that TT was not associated with an improved CSS and OS compared with TL with hazard ratio (HR) and 95% confidence interval (CI) of 0.53 (0.25-1.12) and 0.86 (0.72-1.04), respectively. In addition, the Kaplan–Meier curves further confirmed the similar survival between TL and TT after propensity score matching. The subgroup analysis showed that TT was associated with better CSS for patients < 55 years, those with tumors of gross extrathyroidal extension, CLNM (N1b), and cases not receiving RAI with HR 95% CI of 0.13 (0.02-0.81), 0.12 (0.02-0.66), 0.11 (0.02-0.64) and 0.36 (0.13-0.90), respectively. TT predicted a trend of better OS for patients with N1b and distant metastasis after adjustment. In addition, TT was associated with better CSS than TL for patients with risk factors like N1b combined with gross extrathyroidal extension, and/or multifocality after matching. In conclusion, TL may be enough for low-risk PTMC patients. TT may improve the prognosis of unilateral PTMC patients with 2 or more risk clinicopathologic factors like CLNM, multifocality, extrathyroidal extension and a younger age compared with TL.

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