Total thyroidectomy may be more reasonable as initial surgery in unilateral multifocal papillary thyroid microcarcinoma: a single-center experience

World Journal of Surgical Oncology

Research

Peisong Wang¹  Jia Liu¹  Guang Chen¹  Shuai Xue¹ 

[1] Department of Thyroid Surgery, The First Hospital of Jilin University, 130061, Changchun, People’s Republic of China;

关键词: Papillary thyroid microcarcinoma;    Multifocality;    Hemithyroidectomy;    Risk factors;    Recurrence;   

DOI  :  10.1186/s12957-017-1130-7

 received in 2016-11-28, accepted in 2017-03-06,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe extent of surgery in patients with unilateral multifocal papillary thyroid microcarcinoma (UMPTMC) remains to be controversial. Aimed to improve surgical management of UMPTMC, this study was performed to identify the recurrence of UMPTMC and analyze its predictive factors.MethodsThis study was approved by the Ethical Committee of The First Hospital of the Jilin University, and written informed consent was given by participants for their clinical records to be used in this study. We retrospectively analyzed a total of 97 consecutive patients who underwent initial surgery for the treatment of UMPTMC at The First Hospital of Jilin University, between October 2005 and October 2006.ResultsAltogether, 97 patients of UMPTMC have been enrolled in our study, in which 57 cases were performed with hemithyroidectomy (HT) while other 40 cases with total thyroidectomy (TT). The sum diameter of all tumors >1 cm was more frequent in HT group than in TT group (40.35 vs 20%; p = 0.046). Positive central lymph nodes were found more frequently in the TT patients than in the HT patients (80 vs 59.65%; p = 0.046). Tumor recurrence was seen more frequently in the HT cases than in the TT cases (26 vs 5%; p = 0.007). The disease-free survival period was significantly shorter for the HT patients than for the TT patients (p = 0.0059 by the log-rank test). The disease-free survival rates at 5 and 10 years were 91.23 and 73.68%, respectively, in the HT group and 100 and 92.5%, respectively, in the TT group. Univariate analysis by Cox’s proportional hazards method showed male gender, sum diameter of all tumors >1 cm, and central lymph node metastases (CLNM) to be risk factors for recurrence of HT patients. Male gender and sum diameter >1 cm were factors identified for multivariate analysis by Cox’s proportional hazards method which yielded risk ratios of 3.037 [CI 1.026–8.988; p = 0.045] and 5.475 [CI 1.389–21.572; p = 0.015] in the HT group.ConclusionsIn summary, with an increased risk of recurrence, TT may be more reasonable as initial surgery in UMPTMC, especially with male gender and total tumor diameter greater than 1 cm.

【 授权许可】

CC BY   
© The Author(s). 2017