Should multifocality be an indication for completion thyroidectomy in papillary thyroid carcinoma? Journal Article


Authors: Harries, V.; Wang, L. Y.; McGill, M.; Xu, B.; Tuttle, R. M.; Wong, R. J.; Shaha, A. R.; Shah, J. P.; Ghossein, R.; Patel, S. G.; Ganly, I.
Article Title: Should multifocality be an indication for completion thyroidectomy in papillary thyroid carcinoma?
Abstract: Background: Multifocality in papillary thyroid carcinoma is common. The aim of this study is to determine whether patients with multifocal disease, treated with lobectomy alone, have an increased risk of contralateral lobe papillary thyroid carcinoma, regional recurrence, and poorer survival. Methods: After institutional review board approval, papillary thyroid carcinoma patients managed from 1986 to 2015 with lobectomy alone were identified from an institutional database. Papillary thyroid carcinoma patients with pT3 to T4 classification, nodal disease, or distant metastases were excluded. After excluding 40 patients who underwent an immediate completion thyroidectomy, 849 were included in the analysis; 619 (72.9%) had unifocal disease and 230 (27.1%) had multifocal disease. Contralateral lobe papillary thyroid carcinoma-free probability, regional recurrence-free probability, disease-specific survival, and overall survival were calculated using the Kaplan-Meier method. Results: With a median follow-up of 58 months, unifocal disease and multifocal disease patients had similar rates of contralateral lobe papillary thyroid carcinoma, regional recurrence, and overall survival (10-year contralateral lobe papillary thyroid carcinoma-free probability 98.6% vs 97.8%; regional recurrence-free probability 99.5% vs 99.4%; overall survival 91.6% vs 93.1%, respectively). There were no disease-related deaths. Conclusion: Select multifocal disease patients, managed with lobectomy alone, have rates of contralateral lobe papillary thyroid carcinoma, regional recurrence, and overall survival comparable to unifocal disease patients. Multifocal disease should not be an indication for completion thyroidectomy. © 2019 Elsevier Inc.
Keywords: adult; cancer survival; controlled study; treatment outcome; major clinical study; overall survival; cancer recurrence; conference paper; cancer staging; follow up; treatment indication; tumor volume; incidence; risk factor; thyroidectomy; lobectomy; thyroid papillary carcinoma; disease specific survival; disease exacerbation; local recurrence free survival; human; male; female; priority journal; contralateral lobe papillary thyroid carcinoma free survival
Journal Title: Surgery
Volume: 167
Issue: 1
ISSN: 0039-6060
Publisher: Elsevier Inc.  
Date Published: 2020-01-01
Start Page: 10
End Page: 16; discussion 17
Language: English
DOI: 10.1016/j.surg.2019.03.031
PUBMED: 31515125
PROVIDER: scopus
PMCID: PMC6904525
DOI/URL:
Notes: Source: Scopus
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MSK Authors
  1. Ronald A Ghossein
    327 Ghossein
  2. Ashok R Shaha
    561 Shaha
  3. Snehal G Patel
    310 Patel
  4. Robert M Tuttle
    377 Tuttle
  5. Richard J Wong
    242 Wong
  6. Ian Ganly
    267 Ganly
  7. Jatin P Shah
    581 Shah
  8. Laura Wang
    36 Wang
  9. Bin   Xu
    82 Xu
  10. Marlena Rose McGill
    8 McGill