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Relation between surgical oncologic quality indicators for papillary thyroid cancer

BACKGROUND: It remains unclear how thyroid surgical oncologic quality indicators (TSOQIs) are related to each other, and how to best interpret and apply these measures within the context of surgical quality assurance. We aimed to examine the relation between 3 TSOQIs: postoperative serum thyroglobul...

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Autores principales: Mak, Nicole, Van Esch, Kristen, Wiseman, Sam M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: CMA Impact Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9536784/
https://www.ncbi.nlm.nih.gov/pubmed/36195340
http://dx.doi.org/10.1503/cjs.009121
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author Mak, Nicole
Van Esch, Kristen
Wiseman, Sam M.
author_facet Mak, Nicole
Van Esch, Kristen
Wiseman, Sam M.
author_sort Mak, Nicole
collection PubMed
description BACKGROUND: It remains unclear how thyroid surgical oncologic quality indicators (TSOQIs) are related to each other, and how to best interpret and apply these measures within the context of surgical quality assurance. We aimed to examine the relation between 3 TSOQIs: postoperative serum thyroglobulin level, 24-hour radioactive iodine uptake (RAIU) and metastatic lymph node ratio (MLNR). METHODS: We conducted a retrospective review of patients who underwent total thyroidectomy for treatment of papillary thyroid cancer (PTC) performed by a single high-volume thyroid surgeon at a tertiary referral centre between 2012 and 2017. To establish the strength of correlation between pairs of quality indicators and the MACIS (metastasis, age, completeness of resection, invasion and size) prognostic score, we performed tests of normality and used the Spearman correlation coefficient to determine the correlation of nonnormal data containing outliers. RESULTS: A total of 139 patients with PTC were included in the study. Their mean MACIS score was 5.0 (standard deviation 1.5). Fifteen patients had high-risk thyroid cancer (MACIS score > 6.99). A weak correlation was found between serum thyroglobulin level and RAIU (r(s) = 0.27, p = 0.006) and a moderate correlation was found between serum thyroglobulin level and MLNR (r(s) = 0.40 p = 0.002). A weak correlation between serum thyroglobulin level and MACIS score was also observed (r(s) = 0.20, p = 0.05). CONCLUSION: Based on our findings, we propose that the postoperative serum thyroglobulin level represents the quality metric that has the most clinical utility because it is measurable in all patients and also correlates with both RAIU and MLNR. With further research, surgeons seeking to evaluate the oncologic quality of thyroidectomy performed for PTC may consider applying a quality indicator to their future practice.
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spelling pubmed-95367842022-10-13 Relation between surgical oncologic quality indicators for papillary thyroid cancer Mak, Nicole Van Esch, Kristen Wiseman, Sam M. Can J Surg Research BACKGROUND: It remains unclear how thyroid surgical oncologic quality indicators (TSOQIs) are related to each other, and how to best interpret and apply these measures within the context of surgical quality assurance. We aimed to examine the relation between 3 TSOQIs: postoperative serum thyroglobulin level, 24-hour radioactive iodine uptake (RAIU) and metastatic lymph node ratio (MLNR). METHODS: We conducted a retrospective review of patients who underwent total thyroidectomy for treatment of papillary thyroid cancer (PTC) performed by a single high-volume thyroid surgeon at a tertiary referral centre between 2012 and 2017. To establish the strength of correlation between pairs of quality indicators and the MACIS (metastasis, age, completeness of resection, invasion and size) prognostic score, we performed tests of normality and used the Spearman correlation coefficient to determine the correlation of nonnormal data containing outliers. RESULTS: A total of 139 patients with PTC were included in the study. Their mean MACIS score was 5.0 (standard deviation 1.5). Fifteen patients had high-risk thyroid cancer (MACIS score > 6.99). A weak correlation was found between serum thyroglobulin level and RAIU (r(s) = 0.27, p = 0.006) and a moderate correlation was found between serum thyroglobulin level and MLNR (r(s) = 0.40 p = 0.002). A weak correlation between serum thyroglobulin level and MACIS score was also observed (r(s) = 0.20, p = 0.05). CONCLUSION: Based on our findings, we propose that the postoperative serum thyroglobulin level represents the quality metric that has the most clinical utility because it is measurable in all patients and also correlates with both RAIU and MLNR. With further research, surgeons seeking to evaluate the oncologic quality of thyroidectomy performed for PTC may consider applying a quality indicator to their future practice. CMA Impact Inc. 2022-10-04 /pmc/articles/PMC9536784/ /pubmed/36195340 http://dx.doi.org/10.1503/cjs.009121 Text en © 2022 CMA Impact Inc. or its licensors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Research
Mak, Nicole
Van Esch, Kristen
Wiseman, Sam M.
Relation between surgical oncologic quality indicators for papillary thyroid cancer
title Relation between surgical oncologic quality indicators for papillary thyroid cancer
title_full Relation between surgical oncologic quality indicators for papillary thyroid cancer
title_fullStr Relation between surgical oncologic quality indicators for papillary thyroid cancer
title_full_unstemmed Relation between surgical oncologic quality indicators for papillary thyroid cancer
title_short Relation between surgical oncologic quality indicators for papillary thyroid cancer
title_sort relation between surgical oncologic quality indicators for papillary thyroid cancer
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9536784/
https://www.ncbi.nlm.nih.gov/pubmed/36195340
http://dx.doi.org/10.1503/cjs.009121
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