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Abstract
COMPARATIVE STUDY BETWEEN TOTAL THYROIDECTOMY AND THYROID LOBECTOMY FOR PAPILLARY THYROID CANCER
Dr. Ahmad Hussain Alkarkour*
ABSTRACT
Background: In patients with papillary thyroid carcinoma (PTC), the role of total thyroidectomy (TT) versus that of thyroid lobectomy (TL) has been controversial. Methods: This retrospective study was done at Damascus Hospital (AlMujtahid hospital). 82 patients with 1- to 5-cm stage cN0 and cM0 PTC tumors treated by curative surgery from 2015 to 2018 were evaluated. Clinic pathologic features and adverse events were compared between patients who underwent TT and those who underwent TL. After adjustment for differences in baseline clinicopathologic factors using propensity score matching, we compared recurrence-free survival (RFS) and OS. Results: TL was performed in 50 patients and TT in 32 patients. Patients who underwent TT were older; had larger tumors; more frequently had nodal metastasis, multifocal tumors, and extracapsular invasion; and more frequently underwent radioactive iodine ablation than patients who underwent TL. Hypocalcemia requiring medication and recurrent laryngeal nerve paralysis were more frequent in TT than TL. The 5-year RFS and OS of all patients were 93.3% and 96.7%, respectively. There was no significant difference in RFS (90.6% vs 93.0% in TT and TL groups, respectively) or OS (96.2% vs 96.9% in TT and TL groups, respectively) according to the extent of surgical resection after propensity score matching. Conclusion: Equivalent prognoses were observed for patients with 1- to 5-cm stage cN0 and cM0 PTC tumors treated by TL or TT after propensity score matching. Adverse events occurred less frequently in patients who underwent TL than TT.
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