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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

DOI https://doi.org/10.2147/CMAR.S249324

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
Email wangyongkun923@163.com

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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