Erschienen in:
30.09.2016 | Invited Commentary
The Extent of Surgery for Papillary Thyroid Microcarcinoma: The Controversy Continues
verfasst von:
C. R. McHenry, H. Shi
Erschienen in:
World Journal of Surgery
|
Ausgabe 1/2017
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Excerpt
The results of the study “How Many Contralateral Carcinomas in Patients with Unilateral Papillary Thyroid Microcarcinoma are Misdiagnosed Preoperatively as Benign?” by Wu and co-authors raises some important issues [
1]. The first is that 29 % of patients with papillary microcarcinoma have disease involving both lobes of the thyroid gland. Knowing that papillary microcarcinoma is an indolent cancer, with a recurrence-free survival of 97 % for tumors ≤5 mm and 86 % for tumors >5 mm at 35 years follow-up [
2], raises a question regarding the significance of occult microscopic disease in the opposite lobe of the thyroid gland. What we do not know for sure is what the outcome would have been in the 29 % of patients had they not had the contralateral lobe of the thyroid gland removed. The advantages of leaving the contralateral lobe of the thyroid gland are that it does not expose the patient to further operative morbidity including recurrent laryngeal injury and hypoparathyroidism and it may obviate the need for exogenous thyroid hormone. …
