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Erschienen in: Indian Journal of Surgery 6/2021

13.01.2021 | Original Article

A Clinical Audit of Hemithyroidectomy for Differentiated Thyroid Cancer—Experience from a Tertiary Cancer Center

verfasst von: Nithyanand Chidambaranathan, Shivakumar Thiagarajan, Nandini Menon, Adhara Chakraborthy, Richa Vaish, Devendra Chaukar

Erschienen in: Indian Journal of Surgery | Ausgabe 6/2021

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Abstract

Existing guidelines recommend lobectomy/hemithyroidectomy (HT) for low-risk thyroid cancer. They are considered safer with lesser complications compared to total thyroidectomy. However, HT is also associated with certain complications. We conducted this retrospective clinical audit of all patients who underwent HT for DTC in our institute from January 2012 to December 2018. The aim of the study was to assess the complications following HT and the follow-up of these patients subsequently. A total of 128 patients satisfied the eligibility criteria. The majority of the patients were women (n = 103, 80.5%). The median age of the patients was 36.5 years (range: 19–77 years). Neck swelling was the most common presentation. All patients underwent conventional open hemithyroidectomy. Five patients had 1–2 metastatic nodes in the central compartment; however, none had metastatic nodes in the lateral neck. Biochemical hypocalcemia (n = 16, 12.5%) was the most common postoperative complication followed by recurrent laryngeal nerve palsy (n = 5, 3.9%). Twenty-six patients developed hypothyroidism at a median duration of 6.5 months following HT necessitating replacement therapy. None of the patients developed recurrence during follow-up (median of 27.5 months). HT is a feasible treatment option for patients with carefully selected cases of DTC. However, HT is also associated with certain complications that should be kept in mind, and patients should be counseled accordingly.
Literatur
1.
Zurück zum Zitat Ahn HS, Kim HJ, Welch HG (2014) Korea’s thyroid-cancer “epidemic”--screening and overdiagnosis. N Engl J Med 371(19):1765–1767CrossRef Ahn HS, Kim HJ, Welch HG (2014) Korea’s thyroid-cancer “epidemic”--screening and overdiagnosis. N Engl J Med 371(19):1765–1767CrossRef
2.
Zurück zum Zitat Seib CD, Sosa JA (2019) Evolving understanding of the epidemiology of thyroid cancer. Endocrinol Metab Clin N Am 48:23–35CrossRef Seib CD, Sosa JA (2019) Evolving understanding of the epidemiology of thyroid cancer. Endocrinol Metab Clin N Am 48:23–35CrossRef
3.
Zurück zum Zitat Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L (2016) 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid. 26(1):1–133CrossRef Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L (2016) 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid. 26(1):1–133CrossRef
4.
Zurück zum Zitat Amin MB, Edge SB, Greene FL, Byrd DR, Brookland RK, Washington MK et al (eds) (2017) AJCC cancer staging manual, 8th edn. Springer-Verlag, New York Amin MB, Edge SB, Greene FL, Byrd DR, Brookland RK, Washington MK et al (eds) (2017) AJCC cancer staging manual, 8th edn. Springer-Verlag, New York
5.
Zurück zum Zitat Chan S, Karamali K, Kolodziejczyk A, Oikonomou G, Watkinson J, Paleri V, Nixon I, Kim D (2020) Systematic review of recurrence rate after hemithyroidectomy for low-risk well-differentiated thyroid ccancer. Eur Thyroid J. 9(2):73–84CrossRef Chan S, Karamali K, Kolodziejczyk A, Oikonomou G, Watkinson J, Paleri V, Nixon I, Kim D (2020) Systematic review of recurrence rate after hemithyroidectomy for low-risk well-differentiated thyroid ccancer. Eur Thyroid J. 9(2):73–84CrossRef
6.
Zurück zum Zitat Ahn D, Sohn JH, Jeon JH (2016) Hypothyroidism following hemithyroidectomy: incidence, risk factors, and clinical characteristics. J Clin Endocrinol Metab 101(4):1429–1436CrossRef Ahn D, Sohn JH, Jeon JH (2016) Hypothyroidism following hemithyroidectomy: incidence, risk factors, and clinical characteristics. J Clin Endocrinol Metab 101(4):1429–1436CrossRef
7.
Zurück zum Zitat Verloop H, Louwerens M, Schoones JW, Kievit J, Smit JW, Dekkers OM (2012) Risk of hypothyroidism following hemithyroidectomy: systematic review and meta-analysis of prognostic studies. J Clin Endocrinol Metab 97(7):2243–2255CrossRef Verloop H, Louwerens M, Schoones JW, Kievit J, Smit JW, Dekkers OM (2012) Risk of hypothyroidism following hemithyroidectomy: systematic review and meta-analysis of prognostic studies. J Clin Endocrinol Metab 97(7):2243–2255CrossRef
8.
Zurück zum Zitat Ahn D, Lee GJ, Sohn JH (2019) Levothyroxine supplementation following hemithyroidectomy: incidence, risk factors, and characteristics. Ann Surg Oncol 26(13):4405–4413CrossRef Ahn D, Lee GJ, Sohn JH (2019) Levothyroxine supplementation following hemithyroidectomy: incidence, risk factors, and characteristics. Ann Surg Oncol 26(13):4405–4413CrossRef
9.
Zurück zum Zitat Pantvaidya G, Katna R, Deshmukh A, Nair D, D’Cruz A (2017) Morbidity of central compartment clearance: comparison of lesser versus complete clearance in patients with thyroid cancer. J Can Res Ther 13:102–106CrossRef Pantvaidya G, Katna R, Deshmukh A, Nair D, D’Cruz A (2017) Morbidity of central compartment clearance: comparison of lesser versus complete clearance in patients with thyroid cancer. J Can Res Ther 13:102–106CrossRef
10.
Zurück zum Zitat Yip L, Stang MT, Carty SE (2011) Thyroid carcinoma: the surgeon’s perspective. Radiol Clin N Am 49(3):463–4viCrossRef Yip L, Stang MT, Carty SE (2011) Thyroid carcinoma: the surgeon’s perspective. Radiol Clin N Am 49(3):463–4viCrossRef
11.
Zurück zum Zitat Iñiguez-Ariza NM, Brito JP (2018) Management of low-risk papillary thyroid cancer. Endocrinol Metab (Seoul) 33(2):185–194CrossRef Iñiguez-Ariza NM, Brito JP (2018) Management of low-risk papillary thyroid cancer. Endocrinol Metab (Seoul) 33(2):185–194CrossRef
12.
Zurück zum Zitat Adam MA, Pura J, Gu L, Dinan MA, Tyler DS, Reed SD, Scheri R, Roman SA, Sosa JA (2014) Extent of surgery for papillary thyroid cancer is not associated with survival: an analysis of 61,775 patients. Ann Surg 260:601–607CrossRef Adam MA, Pura J, Gu L, Dinan MA, Tyler DS, Reed SD, Scheri R, Roman SA, Sosa JA (2014) Extent of surgery for papillary thyroid cancer is not associated with survival: an analysis of 61,775 patients. Ann Surg 260:601–607CrossRef
13.
Zurück zum Zitat Bilimoria KY, Bentrem DJ, Ko CY, Stewart AK, Winchester DP, Talamonti MS, Sturgeon C (2007) Extent of surgery affects survival for papillary thyroid cancer. Ann Surg 246:375–384CrossRef Bilimoria KY, Bentrem DJ, Ko CY, Stewart AK, Winchester DP, Talamonti MS, Sturgeon C (2007) Extent of surgery affects survival for papillary thyroid cancer. Ann Surg 246:375–384CrossRef
14.
Zurück zum Zitat Tran B, Roshan D, Abraham E, Wang L, Garibotto N, Wykes J, Campbell P, Ebrahimi A (2018) The prognostic impact of tumor size in papillary thyroid carcinoma is modified by age. Thyroid. 28(8):991–996CrossRef Tran B, Roshan D, Abraham E, Wang L, Garibotto N, Wykes J, Campbell P, Ebrahimi A (2018) The prognostic impact of tumor size in papillary thyroid carcinoma is modified by age. Thyroid. 28(8):991–996CrossRef
15.
Zurück zum Zitat Rahbari R, Zhang L, Kebebew E (2010) Thyroid cancer gender disparity. Future Oncol 6(11):1771–1779CrossRef Rahbari R, Zhang L, Kebebew E (2010) Thyroid cancer gender disparity. Future Oncol 6(11):1771–1779CrossRef
16.
Zurück zum Zitat Wang F, Yu X, Shen X, Zhu G, Huang Y, Liu R, Viola D, Elisei R, Puxeddu E, Fugazzola L, Colombo C, Jarzab B, Czarniecka A, Lam AK, Mian C, Vianello F, Yip L, Riesco-Eizaguirre G, Santisteban P, O’Neill CJ, Sywak MS, Clifton-Bligh R, Bendlova B, Sýkorová V, Wang Y, Liu S, Zhao J, Zhao S, Xing M (2017) The prognostic value of tumor multifocality in clinical outcomes of papillary thyroid cancer. J Clin Endocrinol Metab 102:3241–3250CrossRef Wang F, Yu X, Shen X, Zhu G, Huang Y, Liu R, Viola D, Elisei R, Puxeddu E, Fugazzola L, Colombo C, Jarzab B, Czarniecka A, Lam AK, Mian C, Vianello F, Yip L, Riesco-Eizaguirre G, Santisteban P, O’Neill CJ, Sywak MS, Clifton-Bligh R, Bendlova B, Sýkorová V, Wang Y, Liu S, Zhao J, Zhao S, Xing M (2017) The prognostic value of tumor multifocality in clinical outcomes of papillary thyroid cancer. J Clin Endocrinol Metab 102:3241–3250CrossRef
17.
Zurück zum Zitat Asson AR, Pingpank JF Jr, Wetherington RW, Hanlon AL, Ridge JA (2001) Incidental parathyroidectomy during thyroid surgery does not cause transient symptomatic hypocalcemia. Arch Otolaryngol Head Neck Surg 127:304–308CrossRef Asson AR, Pingpank JF Jr, Wetherington RW, Hanlon AL, Ridge JA (2001) Incidental parathyroidectomy during thyroid surgery does not cause transient symptomatic hypocalcemia. Arch Otolaryngol Head Neck Surg 127:304–308CrossRef
18.
Zurück zum Zitat Attou F, Combemale F, Fabre S, Carnaille B, Decoulx M, Wemeau JL et al (1998) Hypocalcemia following thyroid surgery: incidence and prediction of outcome. World J Surg 22:718–724CrossRef Attou F, Combemale F, Fabre S, Carnaille B, Decoulx M, Wemeau JL et al (1998) Hypocalcemia following thyroid surgery: incidence and prediction of outcome. World J Surg 22:718–724CrossRef
19.
Zurück zum Zitat Sutton RA, Dirks JH (1986) Calcium and magnesium: renal handling and disorders of metabolism. In: Brenner BM, Reector FC (eds) The kidney. WB Saunders, Philadelphia, pp 551–619 Sutton RA, Dirks JH (1986) Calcium and magnesium: renal handling and disorders of metabolism. In: Brenner BM, Reector FC (eds) The kidney. WB Saunders, Philadelphia, pp 551–619
20.
Zurück zum Zitat Baldassarre RL, Chang DC, Brumund KT, Bouvet M (2012) Predictors of hypocalcemia after thyroidectomy: results from the nationwide inpatient sample. ISRN Surgery 2012:1–7CrossRef Baldassarre RL, Chang DC, Brumund KT, Bouvet M (2012) Predictors of hypocalcemia after thyroidectomy: results from the nationwide inpatient sample. ISRN Surgery 2012:1–7CrossRef
21.
Zurück zum Zitat Rosato L, Avenia N, Bernante P, de Palma M, Gulino G, Nasi PG, Pelizzo MR, Pezzullo L (2004) Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J Surg 28(3):271–276CrossRef Rosato L, Avenia N, Bernante P, de Palma M, Gulino G, Nasi PG, Pelizzo MR, Pezzullo L (2004) Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J Surg 28(3):271–276CrossRef
22.
Zurück zum Zitat Gunn A, Oyekunle T, Stang M, Kazaure H, Scheri R (2020) Recurrent laryngeal nerve injury after thyroid surgery: an analysis of 11,370 patients. J Surg Res 255:42–49CrossRef Gunn A, Oyekunle T, Stang M, Kazaure H, Scheri R (2020) Recurrent laryngeal nerve injury after thyroid surgery: an analysis of 11,370 patients. J Surg Res 255:42–49CrossRef
23.
Zurück zum Zitat Filetti S, Durante C, Hartl D, Leboulleux S, Locati LD, Newbold K, Papotti MG, Berruti A (2019) Thyroid cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up†. Ann Oncol 30(12):1856–1883CrossRef Filetti S, Durante C, Hartl D, Leboulleux S, Locati LD, Newbold K, Papotti MG, Berruti A (2019) Thyroid cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up†. Ann Oncol 30(12):1856–1883CrossRef
24.
Zurück zum Zitat Chan S, Karamali K, Kolodziejczyk A, Oikonomou G, Watkinson J, Paleri V, Nixon I, Kim D (2020) Systematic review of recurrence rate after hemithyroidectomy for low-risk well-differentiated thyroid cancer. Eur Thyroid J 9(2):73–84CrossRef Chan S, Karamali K, Kolodziejczyk A, Oikonomou G, Watkinson J, Paleri V, Nixon I, Kim D (2020) Systematic review of recurrence rate after hemithyroidectomy for low-risk well-differentiated thyroid cancer. Eur Thyroid J 9(2):73–84CrossRef
Metadaten
Titel
A Clinical Audit of Hemithyroidectomy for Differentiated Thyroid Cancer—Experience from a Tertiary Cancer Center
verfasst von
Nithyanand Chidambaranathan
Shivakumar Thiagarajan
Nandini Menon
Adhara Chakraborthy
Richa Vaish
Devendra Chaukar
Publikationsdatum
13.01.2021
Verlag
Springer India
Erschienen in
Indian Journal of Surgery / Ausgabe 6/2021
Print ISSN: 0972-2068
Elektronische ISSN: 0973-9793
DOI
https://doi.org/10.1007/s12262-020-02703-z

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