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 |
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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 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2550268829</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2550268829</sourcerecordid><originalsourceid>FETCH-LOGICAL-c352t-98674c79d9f797342634d16afc01e78e535d1eaf93f0344e10c6b115879e4ff3</originalsourceid><addsrcrecordid>eNp9kE1LxDAQhoMouK7-AU8BL16q-W5zlMUvWFnB4kkINZ3udmkTTVpk_73RCoIHTzMMzzvzzovQKSUXlAl5GSkRXGSE0YwSXvBM7aEZlWkkVEH3U09UkWmm5CE6inFLCM05kTP08jSGNXiHn3039oArV-Old-ushNDjlbO-8-vW4tU4WN9DxK3Dj9XQghsi_miHDX6Aeuy6KuxwudkF39Z4UQXbOt9Xx-igqboIJz91jsqb63Jxly1Xt_eLq2VmuWRDpguVC5vrWje5zrlgiouaqqqxhEJegOSyplA1mjeECwGUWPVKqSxyDaJp-BydT2vfgn8fIQ6mb6OFZMqBH6NhUhKmioLphJ79Qbd-DC6ZS1S6rQTJRaLYRNngYwzQmLfQ9ulFQ4n5yttMeZuUt_nO26gk4pMoJtitIfyu_kf1CZQOggk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2597364074</pqid></control><display><type>article</type><title>Surgeon Volume and Long-Term Oncologic Outcomes in Patients with Medullary Thyroid Carcinoma</title><source>SpringerLink Journals - AutoHoldings</source><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</creator><creatorcontrib>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</creatorcontrib><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.</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 & 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
< 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><subject>Complications</subject><subject>Endocrine Tumors</subject><subject>Lymph nodes</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Oncology</subject><subject>Patients</subject><subject>Postoperative</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Surgical outcomes</subject><subject>Thyroid cancer</subject><subject>Thyroid carcinoma</subject><subject>Tumors</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kE1LxDAQhoMouK7-AU8BL16q-W5zlMUvWFnB4kkINZ3udmkTTVpk_73RCoIHTzMMzzvzzovQKSUXlAl5GSkRXGSE0YwSXvBM7aEZlWkkVEH3U09UkWmm5CE6inFLCM05kTP08jSGNXiHn3039oArV-Old-ushNDjlbO-8-vW4tU4WN9DxK3Dj9XQghsi_miHDX6Aeuy6KuxwudkF39Z4UQXbOt9Xx-igqboIJz91jsqb63Jxly1Xt_eLq2VmuWRDpguVC5vrWje5zrlgiouaqqqxhEJegOSyplA1mjeECwGUWPVKqSxyDaJp-BydT2vfgn8fIQ6mb6OFZMqBH6NhUhKmioLphJ79Qbd-DC6ZS1S6rQTJRaLYRNngYwzQmLfQ9ulFQ4n5yttMeZuUt_nO26gk4pMoJtitIfyu_kf1CZQOggk</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Park, Hyunju</creator><creator>Kim, Hye In</creator><creator>Choe, Jun-Ho</creator><creator>Chung, Man Ki</creator><creator>Son, Young Ik</creator><creator>Hahn, Soo Yeon</creator><creator>Hwang, Na-young</creator><creator>Woo, Sook-young</creator><creator>Kim, Sun Wook</creator><creator>Chung, Jae Hoon</creator><creator>Kim, Tae Hyuk</creator><creator>Kim, Jee Soo</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7975-2437</orcidid></search><sort><creationdate>20211201</creationdate><title>Surgeon Volume and Long-Term Oncologic Outcomes in Patients with Medullary Thyroid Carcinoma</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-98674c79d9f797342634d16afc01e78e535d1eaf93f0344e10c6b115879e4ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Complications</topic><topic>Endocrine Tumors</topic><topic>Lymph nodes</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Oncology</topic><topic>Patients</topic><topic>Postoperative</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Surgical outcomes</topic><topic>Thyroid cancer</topic><topic>Thyroid carcinoma</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><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><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, Hyunju</au><au>Kim, Hye In</au><au>Choe, Jun-Ho</au><au>Chung, Man Ki</au><au>Son, Young Ik</au><au>Hahn, Soo Yeon</au><au>Hwang, Na-young</au><au>Woo, Sook-young</au><au>Kim, Sun Wook</au><au>Chung, Jae Hoon</au><au>Kim, Tae Hyuk</au><au>Kim, Jee Soo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgeon Volume and Long-Term Oncologic Outcomes in Patients with Medullary Thyroid Carcinoma</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><date>2021-12-01</date><risdate>2021</risdate><volume>28</volume><issue>13</issue><spage>8863</spage><epage>8871</epage><pages>8863-8871</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>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.</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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source | SpringerLink Journals - AutoHoldings |
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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