Original CommunicationThyroid lobectomy for treatment of well differentiated intrathyroid malignancy
Section snippets
Methods
Following approval by the Institutional Review Board, 889 patients (49%) who had thyroid surgery for T1T2 N0 cancer (using the 2009 AJCC staging manual11; T1: <2 cm, T2: 2–4 cm) between 1986 and 2005, were identified from our institutional database of 1810 patients treated for WDTC at MSKCC. Patients who underwent initial treatment elsewhere prior to referral or those who were considered unresectable at the time of referral were excluded.
Data collected included patient demographics, surgical
Entire group
The male to female ratio was about 2:7 (188 men and 701 women). The median age was 46 years (range, 4–91). Eight hundred patients (90%) had papillary carcinoma, 52 patients (6%) had follicular carcinoma, and 37 (4%) had Hürthle cell carcinoma. Nineteen patients were classified as having tall cell variant of papillary carcinoma. Although tall cell variant does have a slightly poorer outcome,12 we still consider this in the WDTC category.
Patient, tumor, and treatment details are shown in Table I.
Discussion
The surgical management of WDTC is based upon reports from retrospective data from both single institutional datasets and national cancer registries. It is well recognized that prospective, randomized controlled trials of therapy for thyroid cancer are impractical. The excellent survival outcome of patients would require large sample sizes and long follow-up to detect the small therapeutic advantages.14
Management of WDTC confined to the gland (T1T2) forms a significant part of surgical thyroid
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2023, Surgery (United States)Citation Excerpt :It has been established that thyroid lobectomy for T1 or T2 node-negative well-differentiated thyroid cancer is safe and has equivalent outcomes compared with those getting more aggressive surgery with or without adjuvant RAI treatment.12,15–17 It also reduces the potential for complications associated with total thyroidectomy.15 Increasing diagnosis of clinically occult early-stage thyroid cancers has not led to any change in thyroid cancer survival, as many are unlikely to progress to overt clinical disease.13