With High-Risk Factors, Total Thyroidectomy is Preferred for Thyroid Cancer
Authors Han L, Li W, Li Y, Wen W, Yao Y, Wang Y
Received 11 February 2020
Accepted for publication 5 May 2020
Published 20 May 2020 Volume 2020:12 Pages 3713—3719
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Antonella D'Anneo
Lin Han,1 Wenlei Li,2 Yingxue Li,1 Wenjuan Wen,1 Yumin Yao,2 Yongkun Wang2
1Department of Pathology, Liaocheng People’s Hospital, Affiliated to Shandong First Medical University, Liaocheng 252000, Shandong, People’s Republic of China; 2Department of Thyroid Surgery, Liaocheng People’s Hospital, Affiliated to Shandong First Medical University, Liaocheng 252000, Shandong, People’s Republic of China
Correspondence: Yongkun Wang
Department of Thyroid Surgery, Liaocheng People’s Hospital, Affiliated to Shandong First Medical University, Liaocheng 252000, Shandong, People’s Republic of China
Tel/ Fax +86-6358272235
Introduction: Based on thyroid cancer data from patients treated in Liaocheng People’s Hospital in 2017, with Chinese national and regional characteristics, in this study we addressed the controversy of which initial thyroid surgical mode, lobectomy or total thyroidectomy, is most effective.
Patients and Methods: Clinical and pathological data from 552 patients with thyroid cancer, who were initially diagnosed and treated surgically, were collected from the Department of Thyroid Surgery. Among them, 40 patients underwent endoscopic surgery, with resection including lobectomy + central lymph node dissection of the affected lobe, while 512 cases underwent total thyroidectomy + central lymph node dissection.
Results: The metastasis rate for all patients was 59.42%. Further, among patients with bilateral or multiple tumors or capsule invasion, the proportions who developed metastatic disease were 63.54% and 71.19% and 67.46%, respectively. Meanwhile, the incidence of contralateral accidental malignancy was 7.25% after postoperative paraffin pathology.
Discussion: Rates of neck lymph node metastasis are high, particularly among patients with risk factors for poor prognosis. It is recommended that, among patients with risk factors, initial treatment should comprise at least total thyroidectomy + central lymph node dissection in China, to avoid the risks associated with secondary surgery and effects on patient quality of life.
Keywords: thyroid cancer, metastasis, surgery, real world, initial treatment
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