The overtreatment of papillary thyroid microcarcinoma in the community
Copyright © 2024 Elsevier Inc. All rights reserved..
INTRODUCTION: Total thyroidectomy is the traditional primary approach for papillary thyroid cancer. However, recent evidence supports conservative management for low-risk tumors like papillary thyroid microcarcinomas (PTMCs). This study explores the adoption of these practices in our community, using a cancer database to analyze treatment strategies.
METHODS: A retrospective review of a 1433-patient institutional database identified 258 PTMC cases. Outcomes, including 30-day mortality, reoperation rate, postoperative hypocalcemia, and recurrent laryngeal nerve (RLN) injury, were assessed.
RESULTS: Of PTMC patients, 63.4% underwent total thyroidectomy, with higher rates of RLN injury (8.8% vs. 2.3%) and hypocalcemia (12.4% vs. 0.0%) compared to lobectomy. Non-endocrine surgeons had higher postoperative radioactive iodine administration rates (28.6% vs. 6.1%). Subgroup analysis revealed a shift in total thyroidectomy rates based on tumor size and surgery period.
CONCLUSION: Our community favors total thyroidectomy for PTMC, despite associated complications. Enhanced awareness and adherence to PTMC best practice guidelines are warranted.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
American journal of surgery - (2024) vom: 04. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Abraham, Peter J [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Revised 10.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.amjsurg.2024.03.004 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369521439 |
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| 100 | 1 | |a Abraham, Peter J |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The overtreatment of papillary thyroid microcarcinoma in the community |
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| 500 | |a Date Revised 10.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 Elsevier Inc. All rights reserved. | ||
| 520 | |a INTRODUCTION: Total thyroidectomy is the traditional primary approach for papillary thyroid cancer. However, recent evidence supports conservative management for low-risk tumors like papillary thyroid microcarcinomas (PTMCs). This study explores the adoption of these practices in our community, using a cancer database to analyze treatment strategies | ||
| 520 | |a METHODS: A retrospective review of a 1433-patient institutional database identified 258 PTMC cases. Outcomes, including 30-day mortality, reoperation rate, postoperative hypocalcemia, and recurrent laryngeal nerve (RLN) injury, were assessed | ||
| 520 | |a RESULTS: Of PTMC patients, 63.4% underwent total thyroidectomy, with higher rates of RLN injury (8.8% vs. 2.3%) and hypocalcemia (12.4% vs. 0.0%) compared to lobectomy. Non-endocrine surgeons had higher postoperative radioactive iodine administration rates (28.6% vs. 6.1%). Subgroup analysis revealed a shift in total thyroidectomy rates based on tumor size and surgery period | ||
| 520 | |a CONCLUSION: Our community favors total thyroidectomy for PTMC, despite associated complications. Enhanced awareness and adherence to PTMC best practice guidelines are warranted | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Lobectomy | |
| 650 | 4 | |a Papillary thyroid microcarcinoma | |
| 650 | 4 | |a Thyroid cancer | |
| 650 | 4 | |a Total thyroidectomy | |
| 700 | 1 | |a Wu, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Rongzhi |e verfasserin |4 aut | |
| 700 | 1 | |a Herring, Brendon |e verfasserin |4 aut | |
| 700 | 1 | |a Zmijewski, Polina |e verfasserin |4 aut | |
| 700 | 1 | |a Gillis, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Fazendin, Jessica |e verfasserin |4 aut | |
| 700 | 1 | |a Lindeman, Brenessa |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Herbert |e verfasserin |4 aut | |
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