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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
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 a...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070212/ https://www.ncbi.nlm.nih.gov/pubmed/36303039 http://dx.doi.org/10.1007/s00268-022-06813-5 |
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author | 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. |
author_facet | 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. |
author_sort | Lin, J. F. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-10070212 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-100702122023-04-05 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 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. World J Surg Original Scientific Report 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. Springer International Publishing 2022-10-27 2023 /pmc/articles/PMC10070212/ /pubmed/36303039 http://dx.doi.org/10.1007/s00268-022-06813-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Scientific Report 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. 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 |
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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
topic | Original Scientific Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070212/ https://www.ncbi.nlm.nih.gov/pubmed/36303039 http://dx.doi.org/10.1007/s00268-022-06813-5 |
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