Extent of Surgery did not Affect Recurrence During 7-Years Follow-up in Papillary Thyroid Cancer Sized 1–4 cm: Preliminary Results

Abstract

Objective

There is debate whether hemithyroidectomy is sufficient for patients with papillary thyroid cancer (PTC) sized 1–4 cm. Therefore, we investigated whether hemithyroidectomy affects recurrence rate compared with thyroidectomy in patients with PTC sized 1–4 cm.

Design

Retrospective observational study.

Patients

We included 147 patients with 1–4 cm PTC who underwent hemithyroidectomy between 2004 and 2008. They were matched with 298 patients who underwent thyroidectomy, comparing age, sex, tumor size, multiplicity, and extrathyroidal extension status, and lymph node (LN) metastasis status.

Measurements

Recurrence-free survival was compared between hemithyroidectomy and thyroidectomy groups.

Results

Median follow-up length was 7 years, during which there were 9 (6.1%) and 17 (5.7%) recurrences in hemithyroidectomy and thyroidectomy group, respectively. Recurrence-free survival in the hemithyroidectomy group was not different from that in the thyroidectomy group regardless of variant, multifocality, LN metastasis, and radioactive iodine treatment. However, in subgroup analysis, hemithyroidectomy significantly increased the risk of recurrence in patients with contralateral nodules on the preoperative imaging.

Conclusions

Recurrence after hemithyroidectomy was not different from that after thyroidectomy during a median follow-up of 7 years. However, because thyroidectomy might be favored in patients with contralateral nodules at preoperative evaluation, a thorough evaluation of the contralateral thyroid lobe is necessary.

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