The time point of completion thyroidectomy has no prognostic impact in patients with differentiated thyroid cancer
Summary Background After partial resection of the thyroid gland, a second operation referred to as “completion thyroidectomy” may be required if histopathological analysis indicates the presence of differentiated thyroid cancer (DTC). Although there is little evidence, it is assumed that the time po...
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| Veröffentlicht in: | Clinical endocrinology (Oxford) 2019-03, Vol.90 (3), p.479-486 |
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| creator | Lenschow, Christina Mäder, Uwe Germer, Christoph‐Thomas Reiners, Christoph Schlegel, Nicolas Verburg, Frederik A. |
| description | Summary
Background
After partial resection of the thyroid gland, a second operation referred to as “completion thyroidectomy” may be required if histopathological analysis indicates the presence of differentiated thyroid cancer (DTC). Although there is little evidence, it is assumed that the time point of completion thyroidectomy is not critical for oncological prognosis of patients with DTC. We assessed whether patients with total thyroidectomy (TTx) in a two‐step procedure have an equal long‐term prognosis with regard to disease‐specific survival (DSS) compared to patients immediately undergoing total thyroidectomy in a one‐step procedure.
Methods
A database study using the Würzburg thyroid cancer database with 2258 patients with pT1a‐pT4b tumours DTC who were operated between 1980 and 2016 was carried out.
Results
A total of 277 patients with papillary microcarcinoma pT1aN0M0 were treated by hemithyroidectomy. TTx as one‐step procedure was performed in 1114 patients compared to 867 with TTx as a two‐step procedure. Patients with papillary thyroid cancer more frequently had a TTx as one‐step procedure than follicular thyroid cancer patients (59.4% vs 47%; P |
| doi_str_mv | 10.1111/cen.13916 |
| format | Article |
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Background
After partial resection of the thyroid gland, a second operation referred to as “completion thyroidectomy” may be required if histopathological analysis indicates the presence of differentiated thyroid cancer (DTC). Although there is little evidence, it is assumed that the time point of completion thyroidectomy is not critical for oncological prognosis of patients with DTC. We assessed whether patients with total thyroidectomy (TTx) in a two‐step procedure have an equal long‐term prognosis with regard to disease‐specific survival (DSS) compared to patients immediately undergoing total thyroidectomy in a one‐step procedure.
Methods
A database study using the Würzburg thyroid cancer database with 2258 patients with pT1a‐pT4b tumours DTC who were operated between 1980 and 2016 was carried out.
Results
A total of 277 patients with papillary microcarcinoma pT1aN0M0 were treated by hemithyroidectomy. TTx as one‐step procedure was performed in 1114 patients compared to 867 with TTx as a two‐step procedure. Patients with papillary thyroid cancer more frequently had a TTx as one‐step procedure than follicular thyroid cancer patients (59.4% vs 47%; P < 0.001). Compared to a one‐step thyroidectomy, overall complication rate was not different compared to patients undergoing a single operation. Multivariate analysis showed that the presence of distant metastases, T‐stage and age at diagnosis were the only independent determinants for DTC‐specific survival, regardless of a one‐ or two‐time thyroidectomy.
Conclusion
The present study on the largest of such patient collectives provides evidence that a delayed completion operation does not affect DSS in DTC, nor does it lead to a significant increase in complication rates.</description><identifier>ISSN: 0300-0664</identifier><identifier>EISSN: 1365-2265</identifier><identifier>DOI: 10.1111/cen.13916</identifier><identifier>PMID: 30548672</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; completion thyroidectomy ; complications ; differentiated thyroid cancer ; Female ; Germany - epidemiology ; Health risk assessment ; hemithyroidectomy ; Humans ; Male ; Medical prognosis ; Metastases ; Middle Aged ; Multivariate analysis ; Papillary thyroid cancer ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Prognosis ; Retrospective Studies ; Survival ; Thyroid cancer ; Thyroid Cancer, Papillary - mortality ; Thyroid Cancer, Papillary - surgery ; Thyroid Neoplasms - mortality ; Thyroid Neoplasms - surgery ; Thyroidectomy ; Thyroidectomy - adverse effects ; Thyroidectomy - methods ; Thyroidectomy - statistics & numerical data ; total thyroidectomy ; Tumors ; Young Adult</subject><ispartof>Clinical endocrinology (Oxford), 2019-03, Vol.90 (3), p.479-486</ispartof><rights>2018 John Wiley & Sons Ltd</rights><rights>2018 John Wiley & Sons Ltd.</rights><rights>Copyright © 2019 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3536-271f7d69d71469b471d3e73b93b3ed245ae226725d68cb23e3286dffaf0a9c4a3</citedby><cites>FETCH-LOGICAL-c3536-271f7d69d71469b471d3e73b93b3ed245ae226725d68cb23e3286dffaf0a9c4a3</cites><orcidid>0000-0001-5705-3945</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fcen.13916$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fcen.13916$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30548672$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lenschow, Christina</creatorcontrib><creatorcontrib>Mäder, Uwe</creatorcontrib><creatorcontrib>Germer, Christoph‐Thomas</creatorcontrib><creatorcontrib>Reiners, Christoph</creatorcontrib><creatorcontrib>Schlegel, Nicolas</creatorcontrib><creatorcontrib>Verburg, Frederik A.</creatorcontrib><title>The time point of completion thyroidectomy has no prognostic impact in patients with differentiated thyroid cancer</title><title>Clinical endocrinology (Oxford)</title><addtitle>Clin Endocrinol (Oxf)</addtitle><description>Summary
Background
After partial resection of the thyroid gland, a second operation referred to as “completion thyroidectomy” may be required if histopathological analysis indicates the presence of differentiated thyroid cancer (DTC). Although there is little evidence, it is assumed that the time point of completion thyroidectomy is not critical for oncological prognosis of patients with DTC. We assessed whether patients with total thyroidectomy (TTx) in a two‐step procedure have an equal long‐term prognosis with regard to disease‐specific survival (DSS) compared to patients immediately undergoing total thyroidectomy in a one‐step procedure.
Methods
A database study using the Würzburg thyroid cancer database with 2258 patients with pT1a‐pT4b tumours DTC who were operated between 1980 and 2016 was carried out.
Results
A total of 277 patients with papillary microcarcinoma pT1aN0M0 were treated by hemithyroidectomy. TTx as one‐step procedure was performed in 1114 patients compared to 867 with TTx as a two‐step procedure. Patients with papillary thyroid cancer more frequently had a TTx as one‐step procedure than follicular thyroid cancer patients (59.4% vs 47%; P < 0.001). Compared to a one‐step thyroidectomy, overall complication rate was not different compared to patients undergoing a single operation. Multivariate analysis showed that the presence of distant metastases, T‐stage and age at diagnosis were the only independent determinants for DTC‐specific survival, regardless of a one‐ or two‐time thyroidectomy.
Conclusion
The present study on the largest of such patient collectives provides evidence that a delayed completion operation does not affect DSS in DTC, nor does it lead to a significant increase in complication rates.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>completion thyroidectomy</subject><subject>complications</subject><subject>differentiated thyroid cancer</subject><subject>Female</subject><subject>Germany - epidemiology</subject><subject>Health risk assessment</subject><subject>hemithyroidectomy</subject><subject>Humans</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Metastases</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Papillary thyroid cancer</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Survival</subject><subject>Thyroid cancer</subject><subject>Thyroid Cancer, Papillary - mortality</subject><subject>Thyroid Cancer, Papillary - surgery</subject><subject>Thyroid Neoplasms - mortality</subject><subject>Thyroid Neoplasms - surgery</subject><subject>Thyroidectomy</subject><subject>Thyroidectomy - adverse effects</subject><subject>Thyroidectomy - methods</subject><subject>Thyroidectomy - statistics & numerical data</subject><subject>total thyroidectomy</subject><subject>Tumors</subject><subject>Young Adult</subject><issn>0300-0664</issn><issn>1365-2265</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1P3DAQhq0KVBbaA38AWeICh4A_Yjs5Viv6IaFygXPk2OOuUWKntler_feYLvRQqXMZjfTo0cy8CJ1TckNr3RoIN5T3VH5AK8qlaBiT4gitCCekIVK2J-g052dCiOiI-ohOOBFtJxVbofS4AVz8DHiJPhQcHTZxXiYoPgZcNvsUvQVT4rzHG51xiHhJ8VeIuXiD_bxoU7APeNHFQygZ73zZYOudg1RnrwvYdw02OhhIn9Cx01OGz2_9DD19vXtcf2_uH779WH-5bwwXXDZMUaes7K2irezHVlHLQfGx5yMHy1qhoZ6pmLCyMyPjwFknrXPaEd2bVvMzdHXw1oV_byGXYfbZwDTpAHGbB0aFkoJ0SlX08h_0OW5TqNtVSvWMEcVIpa4PlEkx5wRuWJKfddoPlAyvQQw1iOFPEJW9eDNuxxnsX_L98xW4PQA7P8H-_6ZhfffzoHwBop-TFw</recordid><startdate>201903</startdate><enddate>201903</enddate><creator>Lenschow, Christina</creator><creator>Mäder, Uwe</creator><creator>Germer, Christoph‐Thomas</creator><creator>Reiners, Christoph</creator><creator>Schlegel, Nicolas</creator><creator>Verburg, Frederik A.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5705-3945</orcidid></search><sort><creationdate>201903</creationdate><title>The time point of completion thyroidectomy has no prognostic impact in patients with differentiated thyroid cancer</title><author>Lenschow, Christina ; Mäder, Uwe ; Germer, Christoph‐Thomas ; Reiners, Christoph ; Schlegel, Nicolas ; Verburg, Frederik A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3536-271f7d69d71469b471d3e73b93b3ed245ae226725d68cb23e3286dffaf0a9c4a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>completion thyroidectomy</topic><topic>complications</topic><topic>differentiated thyroid cancer</topic><topic>Female</topic><topic>Germany - epidemiology</topic><topic>Health risk assessment</topic><topic>hemithyroidectomy</topic><topic>Humans</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Metastases</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Papillary thyroid cancer</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Survival</topic><topic>Thyroid cancer</topic><topic>Thyroid Cancer, Papillary - mortality</topic><topic>Thyroid Cancer, Papillary - surgery</topic><topic>Thyroid Neoplasms - mortality</topic><topic>Thyroid Neoplasms - surgery</topic><topic>Thyroidectomy</topic><topic>Thyroidectomy - adverse effects</topic><topic>Thyroidectomy - methods</topic><topic>Thyroidectomy - statistics & numerical data</topic><topic>total thyroidectomy</topic><topic>Tumors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lenschow, Christina</creatorcontrib><creatorcontrib>Mäder, Uwe</creatorcontrib><creatorcontrib>Germer, Christoph‐Thomas</creatorcontrib><creatorcontrib>Reiners, Christoph</creatorcontrib><creatorcontrib>Schlegel, Nicolas</creatorcontrib><creatorcontrib>Verburg, Frederik A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical endocrinology (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lenschow, Christina</au><au>Mäder, Uwe</au><au>Germer, Christoph‐Thomas</au><au>Reiners, Christoph</au><au>Schlegel, Nicolas</au><au>Verburg, Frederik A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The time point of completion thyroidectomy has no prognostic impact in patients with differentiated thyroid cancer</atitle><jtitle>Clinical endocrinology (Oxford)</jtitle><addtitle>Clin Endocrinol (Oxf)</addtitle><date>2019-03</date><risdate>2019</risdate><volume>90</volume><issue>3</issue><spage>479</spage><epage>486</epage><pages>479-486</pages><issn>0300-0664</issn><eissn>1365-2265</eissn><abstract>Summary
Background
After partial resection of the thyroid gland, a second operation referred to as “completion thyroidectomy” may be required if histopathological analysis indicates the presence of differentiated thyroid cancer (DTC). Although there is little evidence, it is assumed that the time point of completion thyroidectomy is not critical for oncological prognosis of patients with DTC. We assessed whether patients with total thyroidectomy (TTx) in a two‐step procedure have an equal long‐term prognosis with regard to disease‐specific survival (DSS) compared to patients immediately undergoing total thyroidectomy in a one‐step procedure.
Methods
A database study using the Würzburg thyroid cancer database with 2258 patients with pT1a‐pT4b tumours DTC who were operated between 1980 and 2016 was carried out.
Results
A total of 277 patients with papillary microcarcinoma pT1aN0M0 were treated by hemithyroidectomy. TTx as one‐step procedure was performed in 1114 patients compared to 867 with TTx as a two‐step procedure. Patients with papillary thyroid cancer more frequently had a TTx as one‐step procedure than follicular thyroid cancer patients (59.4% vs 47%; P < 0.001). Compared to a one‐step thyroidectomy, overall complication rate was not different compared to patients undergoing a single operation. Multivariate analysis showed that the presence of distant metastases, T‐stage and age at diagnosis were the only independent determinants for DTC‐specific survival, regardless of a one‐ or two‐time thyroidectomy.
Conclusion
The present study on the largest of such patient collectives provides evidence that a delayed completion operation does not affect DSS in DTC, nor does it lead to a significant increase in complication rates.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30548672</pmid><doi>10.1111/cen.13916</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-5705-3945</orcidid></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Child Child, Preschool completion thyroidectomy complications differentiated thyroid cancer Female Germany - epidemiology Health risk assessment hemithyroidectomy Humans Male Medical prognosis Metastases Middle Aged Multivariate analysis Papillary thyroid cancer Postoperative Complications - epidemiology Postoperative Complications - etiology Prognosis Retrospective Studies Survival Thyroid cancer Thyroid Cancer, Papillary - mortality Thyroid Cancer, Papillary - surgery Thyroid Neoplasms - mortality Thyroid Neoplasms - surgery Thyroidectomy Thyroidectomy - adverse effects Thyroidectomy - methods Thyroidectomy - statistics & numerical data total thyroidectomy Tumors Young Adult |
| title | The time point of completion thyroidectomy has no prognostic impact in patients with differentiated thyroid cancer |
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