Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
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Is Completion Thyroidectomy Necessary in Patients with Papillary Thyroid Carcinoma who Underwent Lobectomy?

엽절제술을 시행한 갑상선 유두암 환자에서 완결 갑상선 절제술이 필요한지에 대한 연구

  • Kang, Il Ku (Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Kim, Kwangsoon (Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Bae, Ja Seong (Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Kim, Jeong Soo (Department of Surgery, College of Medicine, The Catholic University of Korea)
  • 강일구 (가톨릭대학교 서울성모병원 외과) ;
  • 김광순 (가톨릭대학교 서울성모병원 외과) ;
  • 배자성 (가톨릭대학교 서울성모병원 외과) ;
  • 김정수 (가톨릭대학교 서울성모병원 외과)
  • Received : 2021.07.01
  • Accepted : 2021.10.05
  • Published : 2021.11.30
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Abstract

Background/Objectives: Although thyroid lobectomy recently is considered as sufficient for low-risk papillary thyroid carcinoma (PTC), completion thyroidectomy is required due to the insufficiency of the preoperative evaluation. The aim of this study was to investigate recurrence rate and disease free survival depending on the gross extrathyroidal extension (gETE) or the number of metastatic lymph node identified in patients with PTC. Materials & Methods: We assessed 3373 patients with PTC who underwent lobectomy at Seoul St. Mary's Hospital (Seoul, Korea) between January 2009 and December 2014. Clinicopathological characteristics and long-term surgical outcomes were retrospectively analyzed through complete chart reviews. The mean follow-up duration was 97.1 ± 21.4 months. Results: The rate of recurrence was higher in gETE group (1.8% vs. 6.0%, p=0.004), leading to decreased disease free survival in Kaplan-Meier analysis (log-rank p<0.001). N1 group (n=1389) was analyzed into two groups whether the number of positive nodes is more than 5 or less. For the group of the more metastatic nodes, the recurrence rate higher compared to the other group (3.0% vs. 9.3%, p<0.001). DFS was longer in the group that had lesser metastatic nodes (log-rank p<0.001). However, in terms of N1 group over 1cm (n=492), No statistical difference was observed according to the number of positive lymph nodes (4.5% vs. 9.1%, p=0.092) Conclusion: When it comes to node positive PTC, Despite the number of positive lymph nodes was over 5, follow-up with no further surgery can be an option.

Keywords

Acknowledgement

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2015R1D1A1A01058798).

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