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Efficacy of hemithyroidectomy in papillary thyroid carcinoma with minimal extrathyroidal extension

  • Yong Bae Ji
  • Chang Myeon Song
  • Donghwan Kim
  • Eui-Suk Sung
  • Dong Won Lee
  • Min Sung Chung
  • Kyung TaeEmail author
Head and Neck
  • 7 Downloads

Abstract

Purpose

This study aimed to compare the oncologic outcomes of hemithyroidectomy with total thyroidectomy in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) with minimal extrathyroidal extension (ETE).

Methods

Among 1826 PTC patients who underwent thyroidectomy from Jan 2001 to Dec 2014, there were 255 with unilateral cN0 PTC with minimal ETE and of equal to or less than 2 cm in size; these 255 patients were included in this study. We excluded patients who had tumor size > 2 cm, bilateral tumors, clinically positive nodes, maximal or no ETE, gross invasion of sternothyroid muscle, recurrent cancers or distant metastases. Total thyroidectomy was performed in 173 of the 255 patients, and hemithyroidectomy in 82 of them. A propensity score-matched analysis was carried out to reduce selection bias, with the following covariates: sex, age, tumor size, multiplicity and central neck dissection.

Results

In the baseline data of the 255 patients, female, age and tumor size were significantly higher in the total thyroidectomy group as was Stage III, whereas T and N classification did not differ in the two groups. Propensity score matching generated two matched groups of 66 patients each, in which the significant differences between the two groups seen in the baseline analysis disappeared. In the matched samples, recurrence rate (3.0% vs. 1.5%, p = 1.0) and recurrence-free survival curves did not differ between total thyroidectomy and hemithyroidectomy.

Conclusions

Hemithyroidectomy can be recommended for cN0 PTC 1 cm or less with minimal ETE. Also it can be considered for cN0 PTC 11–20 mm with minimal ETE.

Keywords

Papillary thyroid carcinoma Hemithyroidectomy Extrathyroidal extension Recurrence Propensity score matching 

Notes

Funding

No financial disclosure for any of the authors.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest pertaining to this manuscript.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Otolaryngology-Head and Neck Surgery, College of MedicineHanyang UniversitySeoulRepublic of Korea
  2. 2.Department of Otolaryngology-Head and Neck Surgery, College of MedicinePusan National UniversityYangsanRepublic of Korea
  3. 3.Department of Otorhinolaryngology-Head and Neck Surgery, School of MedicineCatholic University of DaeguDaeguRepublic of Korea
  4. 4.Department of Surgery, College of MedicineHanyang UniversitySeoulRepublic of Korea

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