Skip to main content

Lobectomy Versus Total Thyroidectomy for Follicular Microcarcinomas

  • Chapter
  • First Online:
Difficult Decisions in Endocrine Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

  • 667 Accesses

Abstract

The diagnosis of follicular thyroid cancer <1 cm is most likely to occur after initial thyroid lobectomy. High risk features include widely invasive, extensive angioinvasion (≥4 foci), or presence of distant metastasis and are the primary predictors of poor prognosis. In the absence of these features, thyroid lobectomy is likely adequate for treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hundahl SA, Fleming ID, Fremgen AM, Menck HR. A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985-1995 [see comments]. Cancer. 1998;83(12):2638–48. PMID: 9874472.

    Article  CAS  PubMed  Google Scholar 

  2. Franc B, de la Salmoniere P, Lange F, Hoang C, Louvel A, de Roquancourt A, et al. Interobserver and intraobserver reproducibility in the histopathology of follicular thyroid carcinoma. Hum Pathol. 2003;34(11):1092–100. PMID: 14652809.

    Article  PubMed  Google Scholar 

  3. Aschebrook-Kilfoy B, Grogan RH, Ward MH, Kaplan E, Devesa SS. Follicular thyroid cancer incidence patterns in the United States, 1980–2009. Thyroid. 2013;23(8):1015–21. PMID: 23360496. PMCID: 3752506.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Aschebrook-Kilfoy B, Ward MH, Sabra MM, Devesa SS. Thyroid cancer incidence patterns in the United States by histologic type, 1992–2006. Thyroid. 2011;21(2):125–34. PMID: 21186939. PMCID: 3025182.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Brito JP, Al Nofal A, Montori VM, Hay ID, Morris JC. The impact of subclinical disease and mechanism of detection on the rise in thyroid cancer incidence: a population-based study in Olmsted County, Minnesota during 1935 through 2012. Thyroid. 2015;25(9):999–1007. PMID: 26103159. PMCID: 4560845.

    Article  PubMed  PubMed Central  Google Scholar 

  6. LiVolsi VA, Baloch ZW. Follicular-patterned tumors of the thyroid: the battle of benign vs. malignant vs. so-called uncertain. Endocr Pathol. 2011;22(4):184–9. PMID: 22072271.

    Article  PubMed  Google Scholar 

  7. Cipriani NA, Nagar S, Kaplan SP, White MG, Antic T, Sadow PM, et al. Follicular thyroid carcinoma: how have histologic diagnoses changed in the last half-century and what are the prognostic implications? Thyroid. 2015;25(11):1209–16. PMID: 26440366. PMCID: 4948203.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  8. Liu J, Singh B, Tallini G, Carlson DL, Katabi N, Shaha A, et al. Follicular variant of papillary thyroid carcinoma: a clinicopathologic study of a problematic entity. Cancer. 2006;107(6):1255–64. PMID: 16900519.

    Article  PubMed  Google Scholar 

  9. Lloyd RV, Erickson LA, Casey MB, Lam KY, Lohse CM, Asa SL, et al. Observer variation in the diagnosis of follicular variant of papillary thyroid carcinoma. Am J Surg Pathol. 2004;28(10):1336–40. PMID: 15371949.

    Article  PubMed  Google Scholar 

  10. Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Thyroid. 2009;19(11):1159–65. PMID: 19888858.

    Article  PubMed  Google Scholar 

  11. Sillery JC, Reading CC, Charboneau JW, Henrichsen TL, Hay ID, Mandrekar JN. Thyroid follicular carcinoma: sonographic features of 50 cases. AJR Am J Roentgenol. 2010;194(1):44–54. PMID: 20028904.

    Article  PubMed  Google Scholar 

  12. Haugen BRM, Alexander EK, Bible KC, Doherty G, Mandel SJ, Nikiforov YE, et al. American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2015. PMID: 26462967.

    Google Scholar 

  13. DeLellis R, Lloyd RV, Heitz PU, Eng C. WHO/IARC classification of tumours. 3rd ed. Lyon: IARC Press; 2004.

    Google Scholar 

  14. D’Avanzo A, Treseler P, Ituarte PH, Wong M, Streja L, Greenspan FS, et al. Follicular thyroid carcinoma: histology and prognosis. Cancer. 2004;100(6):1123–9. PMID: 15022277.

    Article  PubMed  Google Scholar 

  15. O’Neill CJ, Vaughan L, Learoyd DL, Sidhu SB, Delbridge LW, Sywak MS. Management of follicular thyroid carcinoma should be individualised based on degree of capsular and vascular invasion. Eur J Surg Oncol. 2011;37(2):181–5. PMID: 21144693.

    Article  PubMed  Google Scholar 

  16. Lee YM, Lee YH, Song DE, Kim WB, Sung TY, Yoon JH, et al. Prognostic impact of further treatments on distant metastasis in patients with minimally invasive follicular thyroid carcinoma: verification using inverse probability of treatment weighting. World J Surg. 2017;41(4):1144. PMID: 28101608.

    Article  PubMed  Google Scholar 

  17. Kim HJ, Sung JY, Oh YL, Kim JH, Son YI, Min YK, et al. Association of vascular invasion with increased mortality in patients with minimally invasive follicular thyroid carcinoma but not widely invasive follicular thyroid carcinoma. Head Neck. 2014;36(12):1695–700. PMID: 24115217.

    Article  PubMed  Google Scholar 

  18. Ito Y, Hirokawa M, Masuoka H, Yabuta T, Kihara M, Higashiyama T, et al. Prognostic factors of minimally invasive follicular thyroid carcinoma: extensive vascular invasion significantly affects patient prognosis. Endocr J. 2013;60(5):637–42. PMID: 23327839.

    Article  PubMed  Google Scholar 

  19. Sugino K, Ito K, Nagahama M, Kitagawa W, Shibuya H, Ohkuwa K, et al. Prognosis and prognostic factors for distant metastases and tumor mortality in follicular thyroid carcinoma. Thyroid. 2011;21(7):751–7. PMID: 21615311.

    Article  PubMed  Google Scholar 

  20. Podda M, Saba A, Porru F, Reccia I, Pisanu A. Follicular thyroid carcinoma: differences in clinical relevance between minimally invasive and widely invasive tumors. World J Surg Oncol. 2015;13:193. PMID: 26041024. PMCID: 4458056.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Lo CY, Chan WF, Lam KY, Wan KY. Follicular thyroid carcinoma: the role of histology and staging systems in predicting survival. Ann Surg. 2005;242(5):708–15. PMID: 16244545. PMCID: 1409851.

    Article  PubMed  PubMed Central  Google Scholar 

  22. D’Avanzo A, Ituarte P, Treseler P, Kebebew E, Wu J, Wong M, et al. Prognostic scoring systems in patients with follicular thyroid cancer: a comparison of different staging systems in predicting the patient outcome. Thyroid. 2004;14(6):453–8. PMID: 15242573.

    Article  PubMed  Google Scholar 

  23. Lang BH, Lo CY, Chan WF, Lam KY, Wan KY. Prognostic factors in papillary and follicular thyroid carcinoma: their implications for cancer staging. Ann Surg Oncol. 2007;14(2):730–8. PMID: 17103065.

    Article  PubMed  Google Scholar 

  24. Sugino K, Kameyama K, Ito K, Nagahama M, Kitagawa W, Shibuya H, et al. Outcomes and prognostic factors of 251 patients with minimally invasive follicular thyroid carcinoma. Thyroid. 2012;22(8):798–804. PMID: 22853727.

    Article  PubMed  Google Scholar 

  25. Lee YM, Song DE, Kim TY, Sung TY, Yoon JH, Chung KW, et al. Risk factors for distant metastasis in patients with minimally invasive follicular thyroid carcinoma. PLoS One. 2016;11(5):e0155489. PMID: 27171147. PMCID: 4865049.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  26. Asari R, Koperek O, Scheuba C, Riss P, Kaserer K, Hoffmann M, et al. Follicular thyroid carcinoma in an iodine-replete endemic goiter region: a prospectively collected, retrospectively analyzed clinical trial. Ann Surg. 2009;249(6):1023–31. PMID: 19474675.

    Article  PubMed  Google Scholar 

  27. Ito Y, Hirokawa M, Higashiyama T, Takamura Y, Miya A, Kobayashi K, et al. Prognosis and prognostic factors of follicular carcinoma in Japan: importance of postoperative pathological examination. World J Surg. 2007;31(7):1417–24. PMID: 17534542.

    Article  PubMed  Google Scholar 

  28. Machens A, Holzhausen HJ, Dralle H. The prognostic value of primary tumor size in papillary and follicular thyroid carcinoma. Cancer. 2005;103(11):2269–73. PMID: 15856429.

    Article  PubMed  Google Scholar 

  29. Kuo EJ, Roman SA, Sosa JA. Patients with follicular and Hurthle cell microcarcinomas have compromised survival: a population level study of 22,738 patients. Surgery. 2013;154(6):1246–53. discussion 53-4. PMID: 23993409.

    Article  PubMed  Google Scholar 

  30. Melo M, da Rocha AG, Vinagre J, Batista R, Peixoto J, Tavares C, et al. TERT promoter mutations are a major indicator of poor outcome in differentiated thyroid carcinomas. J Clin Endocrinol Metab. 2014;99(5):E754–65. PMID: 24476079. PMCID: 4191548.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  31. Dionigi G, Kraimps JL, Schmid KW, Hermann M, Sheu-Grabellus SY, De Wailly P, et al. Minimally invasive follicular thyroid cancer (MIFTC)--a consensus report of the European Society of Endocrine Surgeons (ESES). Langenbecks Arch Surg. 2014;399(2):165–84. PMID: 24233345.

    Article  PubMed  Google Scholar 

  32. Sugino K, Kameyama K, Nagahama M, Kitagawa W, Shibuya H, Ohkuwa K, et al. Does completion thyroidectomy improve the outcome of patients with minimally invasive follicular carcinoma of the thyroid? Ann Surg Oncol. 2014;21(9):2981–6. PMID: 24770681.

    Article  PubMed  Google Scholar 

  33. Goffredo P, Cheung K, Roman SA, Sosa JA. Can minimally invasive follicular thyroid cancer be approached as a benign lesion?: a population-level analysis of survival among 1,200 patients. Ann Surg Oncol. 2013;20(3):767–72. PMID: 23111705.

    Article  PubMed  Google Scholar 

  34. Megwalu UC, Green RW. Total thyroidectomy versus lobectomy for the treatment of follicular thyroid microcarcinoma. Anticancer Res. 2016;36(6):2899–902. PMID: 27272803.

    PubMed  Google Scholar 

  35. Aschebrook-Kilfoy B, James B, Nagar S, Kaplan S, Seng V, Ahsan H, et al. Risk factors for decreased quality of life in thyroid cancer survivors: initial findings from the North American thyroid cancer survivorship study. Thyroid. 2015;25(12):1313–21. PMID: 26431811. PMCID: 4684649.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Applewhite MK, James BC, Kaplan SP, Angelos P, Kaplan EL, Grogan RH, et al. Quality of life in thyroid cancer is similar to that of other cancers with worse survival. World J Surg. 2016;40(3):551–61. PMID: 26546191.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Linwah Yip .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Yip, L. (2018). Lobectomy Versus Total Thyroidectomy for Follicular Microcarcinomas. In: Angelos, P., Grogan, R. (eds) Difficult Decisions in Endocrine Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-319-92860-9_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-92860-9_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-92858-6

  • Online ISBN: 978-3-319-92860-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics