2022, Number 4
<< Back Next >>
Acta Med 2022; 20 (4)
Papillary thyroid carcinoma. How extensive should the surgery be according to the American Thyroid Association?
Boyer DE, Pantoja MJP, Dajer FWL, Rodríguez GA, Sierra SM, Cortés RJJP, Sánchez VLD
Language: Spanish
References: 17
Page: 295-301
PDF size: 183.77 Kb.
ABSTRACT
Objective: To analyze new 2015 guidelines from the American Thyroid Association (ATA) compared to 2009, and their impact on thyroidectomy extension in patients with papillary thyroid carcinoma.
Material and methods: Retrospective study of patients with papillary thyroid cancer, who had surgery in two different periods, 2013-2016 (group A) and 2017-2018 (group B), comparing the number of hemithyroidectomies (HT) vs total thyroidectomies (TT), whether or not to perform lymph node dissection (DG), hospital stay, and perioperative complications.
Results: 108 patients were studied, 54 in each group, comparing group A to group B: there were no differences in the number of HT (3 vs 2) and TT (51 vs 52). Performing a higher number of central DG (22 vs 32) and modified radical 7 vs 9. No significant difference was found in HT surgery time (100.0 ± 29.4 vs 135.0 ± 15.0 min [p = 0.569]), nor in TT (114.0 ± 40.9 vs 127.9 ± 63.8 min [p = 0.877]), bleeding (28.5 ± 45.2 vs 28.9 ± 89.6 mL [p = 0.977]) and length of stay (2.1 ± 1.3 vs 1.9 ± 0.9 [p = 0.374]).
Conclusions: The recommendations of the extension in surgery had no impact on the surgical attitude. Complications were similar.
REFERENCES
Rahib L, Smith BD, Aizenberg R, Rosenzweig AB, Fleshman JM, Matrisian LM. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res. 2014; 74 (11): 2913-2921.
Curado MP, Edwards B, Shin HR, Storm H, Ferlay J, Heanue M et al. Cancer incidence in five continents. Lyon: IARC, WHO; 2007 (volume IX).
Ferlay J, Bray F, Pisani P, Parkin DM. GLOBOCAN 2002: cancer incidence, mortality and prevalence worldwide. IARC Cancer Base No. 5, version 2.0. Lyon: IARC Press; 2004.
Kilfoy BA, Zheng T, Holford TR, Han X, Ward MH, Sjodin A et al. International patterns and trends in thyroid cancer incidence, 1973-2002. Cancer Causes Control. 2009; 20 (5): 525-531.
Hauch A, Al-Qurayshi Z, Randolph G, Kandil E. Total thyroidectomy is associated with increased risk of complications for low- and high-volume surgeons. Ann Surg Oncol. 2014; 21 (12): 3844-3852.
Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016; 26 (1): 1-133.
Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin. 2017; 67 (1): 7-30.
Kim BW, Yousman W, Wong WX, Cheng C, McAninch EA. Less is more: comparing the 2015 and 2009 American Thyroid Association guidelines for thyroid nodules and cancer. Thyroid. 2016; 26 (6): 759-764.
Limaiem F, Rehman A, Mazzoni T. Cancer, papillary thyroid carcinoma (PTC) [Updated 2019 Oct 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019.
International Agency for Research on Cancer. Francia: World Health Organization; [Updated 2018, cited Nov 23, 2019]. Available in: https://gco.iarc.fr
Cancer Genome Atlas Research Network. Integrated genomic characterization of papillary thyroid carcinoma. Cell. 2014; 159 (3): 676-690.
American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009; 19 (11): 1167-1214.
Randolph GW, Duh QY, Heller KS, LiVolsi VA, Mandel SJ, Steward DL et al. The prognostic significance of nodal metastases from papillary thyroid carcinoma can be stratified based on the size and number of metastatic lymph nodes, as well as the presence of extranodal extension. Thyroid. 2012; 22 (11): 1144-1152.
Dermott MM, Gauna A, Yampey J. Impacto del compromiso ganglionar en el pronóstico y la evolución del carcinoma papilar de tiroides. Rev Argent Endocrinol Metab. 2017; 54 (2): 51-63.
Hirsch D, Levy S, Tsvetov G, Shimon I, Benbassat C. Total versus hemithyroidectomy for small unilateral papillary thyroid carcinoma. Oncol Lett. 2014; 7 (3): 849-853.
Esnaola NF, Cantor SB, Sherman SI, Lee JE, Evans DB. Optimal treatment strategy in patients with papillary thyroid cancer: a decision analysis. Surgery. 2001; 130 (6): 921-930.
Kluijfhout WP, Pasternak JD, Lim J, Kwon JS, Vriens MR, Clark OH et al. Frequency of high-risk characteristics requiring total thyroidectomy for 1-4 cm well-differentiated thyroid cancer. Thyroid. 2016; 26 (6): 820-824.