Surgeon Volume and Long-Term Oncologic Outcomes in Patients with Medullary Thyroid Carcinoma

Background Surgery is the most important curative treatment for medullary thyroid carcinoma (MTC). The relationship between surgeon volume (the number of surgeries performed) and short-term surgical outcomes, such as increased postoperative complication or costs, is well established. This study eval...

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Veröffentlicht in:Annals of surgical oncology 2021-12, Vol.28 (13), p.8863-8871
Hauptverfasser: Park, Hyunju, Kim, Hye In, Choe, Jun-Ho, Chung, Man Ki, Son, Young Ik, Hahn, Soo Yeon, Hwang, Na-young, Woo, Sook-young, Kim, Sun Wook, Chung, Jae Hoon, Kim, Tae Hyuk, Kim, Jee Soo
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container_end_page 8871
container_issue 13
container_start_page 8863
container_title Annals of surgical oncology
container_volume 28
creator Park, Hyunju
Kim, Hye In
Choe, Jun-Ho
Chung, Man Ki
Son, Young Ik
Hahn, Soo Yeon
Hwang, Na-young
Woo, Sook-young
Kim, Sun Wook
Chung, Jae Hoon
Kim, Tae Hyuk
Kim, Jee Soo
description Background Surgery is the most important curative treatment for medullary thyroid carcinoma (MTC). The relationship between surgeon volume (the number of surgeries performed) and short-term surgical outcomes, such as increased postoperative complication or costs, is well established. This study evaluated whether surgeon volume influenced long-term oncologic outcomes. Methods We retrospectively reviewed 246 patients diagnosed with MTC after initial thyroid surgery from 1995 to 2019. After exclusion, 194 patients were eligible for inclusion in the study. Surgeons were categorized as low/intermediate volume (fewer than 100 operations per year) or high volume (at least 100 operations per year). Results Of the 194 included patients, 60 (30.9%) developed disease recurrence, and 9 (4.6%) died of MTC during the median follow-up of 92.5 months. Having a low/intermediate-volume surgeon was associated with high disease recurrence (log-rank test, p < 0.001). After adjustment for age, sex, tumor type (sporadic versus hereditary), primary tumor size, presence of central lymph node metastasis (LNM), presence of lateral LNM, extrathyroidal extension, and positive resection margin, surgeon volume was a significant factor for disease recurrence (hazard ratio 2.28, p = 0.004); however, cancer-specific survival was not affected by surgeon volume (hazard ratio 4.16, p = 0.115). Conclusions Surgeon volume is associated with long-term oncologic outcome. MTC patients will be able to make the best decisions for their treatment based on the results of this study.
doi_str_mv 10.1245/s10434-021-10383-6
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The relationship between surgeon volume (the number of surgeries performed) and short-term surgical outcomes, such as increased postoperative complication or costs, is well established. This study evaluated whether surgeon volume influenced long-term oncologic outcomes. Methods We retrospectively reviewed 246 patients diagnosed with MTC after initial thyroid surgery from 1995 to 2019. After exclusion, 194 patients were eligible for inclusion in the study. Surgeons were categorized as low/intermediate volume (fewer than 100 operations per year) or high volume (at least 100 operations per year). Results Of the 194 included patients, 60 (30.9%) developed disease recurrence, and 9 (4.6%) died of MTC during the median follow-up of 92.5 months. Having a low/intermediate-volume surgeon was associated with high disease recurrence (log-rank test, p &lt; 0.001). After adjustment for age, sex, tumor type (sporadic versus hereditary), primary tumor size, presence of central lymph node metastasis (LNM), presence of lateral LNM, extrathyroidal extension, and positive resection margin, surgeon volume was a significant factor for disease recurrence (hazard ratio 2.28, p = 0.004); however, cancer-specific survival was not affected by surgeon volume (hazard ratio 4.16, p = 0.115). Conclusions Surgeon volume is associated with long-term oncologic outcome. MTC patients will be able to make the best decisions for their treatment based on the results of this study.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-021-10383-6</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Complications ; Endocrine Tumors ; Lymph nodes ; Medicine ; Medicine &amp; Public Health ; Metastases ; Oncology ; Patients ; Postoperative ; Surgery ; Surgical Oncology ; Surgical outcomes ; Thyroid cancer ; Thyroid carcinoma ; Tumors</subject><ispartof>Annals of surgical oncology, 2021-12, Vol.28 (13), p.8863-8871</ispartof><rights>Society of Surgical Oncology 2021</rights><rights>Society of Surgical Oncology 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-98674c79d9f797342634d16afc01e78e535d1eaf93f0344e10c6b115879e4ff3</citedby><cites>FETCH-LOGICAL-c352t-98674c79d9f797342634d16afc01e78e535d1eaf93f0344e10c6b115879e4ff3</cites><orcidid>0000-0002-7975-2437</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-021-10383-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-021-10383-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids></links><search><creatorcontrib>Park, Hyunju</creatorcontrib><creatorcontrib>Kim, Hye In</creatorcontrib><creatorcontrib>Choe, Jun-Ho</creatorcontrib><creatorcontrib>Chung, Man Ki</creatorcontrib><creatorcontrib>Son, Young Ik</creatorcontrib><creatorcontrib>Hahn, Soo Yeon</creatorcontrib><creatorcontrib>Hwang, Na-young</creatorcontrib><creatorcontrib>Woo, Sook-young</creatorcontrib><creatorcontrib>Kim, Sun Wook</creatorcontrib><creatorcontrib>Chung, Jae Hoon</creatorcontrib><creatorcontrib>Kim, Tae Hyuk</creatorcontrib><creatorcontrib>Kim, Jee Soo</creatorcontrib><title>Surgeon Volume and Long-Term Oncologic Outcomes in Patients with Medullary Thyroid Carcinoma</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><description>Background Surgery is the most important curative treatment for medullary thyroid carcinoma (MTC). The relationship between surgeon volume (the number of surgeries performed) and short-term surgical outcomes, such as increased postoperative complication or costs, is well established. This study evaluated whether surgeon volume influenced long-term oncologic outcomes. Methods We retrospectively reviewed 246 patients diagnosed with MTC after initial thyroid surgery from 1995 to 2019. After exclusion, 194 patients were eligible for inclusion in the study. Surgeons were categorized as low/intermediate volume (fewer than 100 operations per year) or high volume (at least 100 operations per year). Results Of the 194 included patients, 60 (30.9%) developed disease recurrence, and 9 (4.6%) died of MTC during the median follow-up of 92.5 months. Having a low/intermediate-volume surgeon was associated with high disease recurrence (log-rank test, p &lt; 0.001). After adjustment for age, sex, tumor type (sporadic versus hereditary), primary tumor size, presence of central lymph node metastasis (LNM), presence of lateral LNM, extrathyroidal extension, and positive resection margin, surgeon volume was a significant factor for disease recurrence (hazard ratio 2.28, p = 0.004); however, cancer-specific survival was not affected by surgeon volume (hazard ratio 4.16, p = 0.115). Conclusions Surgeon volume is associated with long-term oncologic outcome. 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The relationship between surgeon volume (the number of surgeries performed) and short-term surgical outcomes, such as increased postoperative complication or costs, is well established. This study evaluated whether surgeon volume influenced long-term oncologic outcomes. Methods We retrospectively reviewed 246 patients diagnosed with MTC after initial thyroid surgery from 1995 to 2019. After exclusion, 194 patients were eligible for inclusion in the study. Surgeons were categorized as low/intermediate volume (fewer than 100 operations per year) or high volume (at least 100 operations per year). Results Of the 194 included patients, 60 (30.9%) developed disease recurrence, and 9 (4.6%) died of MTC during the median follow-up of 92.5 months. Having a low/intermediate-volume surgeon was associated with high disease recurrence (log-rank test, p &lt; 0.001). After adjustment for age, sex, tumor type (sporadic versus hereditary), primary tumor size, presence of central lymph node metastasis (LNM), presence of lateral LNM, extrathyroidal extension, and positive resection margin, surgeon volume was a significant factor for disease recurrence (hazard ratio 2.28, p = 0.004); however, cancer-specific survival was not affected by surgeon volume (hazard ratio 4.16, p = 0.115). Conclusions Surgeon volume is associated with long-term oncologic outcome. MTC patients will be able to make the best decisions for their treatment based on the results of this study.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><doi>10.1245/s10434-021-10383-6</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7975-2437</orcidid></addata></record>
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subjects Complications
Endocrine Tumors
Lymph nodes
Medicine
Medicine & Public Health
Metastases
Oncology
Patients
Postoperative
Surgery
Surgical Oncology
Surgical outcomes
Thyroid cancer
Thyroid carcinoma
Tumors
title Surgeon Volume and Long-Term Oncologic Outcomes in Patients with Medullary Thyroid Carcinoma
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