Thyroid cancer: no survival benefit for total thyroidectomy/RAI in low-risk elders

  • Zambeli-Ljepović A & al.
  • J Surg Res
  • 8 juin 2019

  • Par Brian Richardson, PhD
  • Résumés d'articles
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Takeaway

  • Total thyroidectomy and radioactive iodine (RAI) are not associated with improved disease-specific survival (DSS) in patients aged ≥66 years with T1N0M0 papillary thyroid cancer (PTC).

Why this matters

  • Less aggressive treatment may reduce morbidity and improve QoL, while maintaining an excellent prognosis.

Key results

  • 65.4% of patients underwent total thyroidectomy, 29.0% underwent lobectomy, and 5.6% underwent lobectomy followed by complete thyroidectomy.
  • 33.4% of patients received postoperative RAI.
  • Tumor size of 1.1-2 cm was associated with extent of surgery (OR, 3.96 [P<.01 for completion thyroidectomy or total and rai>
  • Multifocality was associated with extent of surgery (OR, 3.51 [P<.01 for completion thyroidectomy or total and rai>
  • Preoperative PTC diagnosis was associated with extent of surgery (OR, 0.52 [P<.01 for completion thyroidectomy or total and rai>
  • Extent of surgery (aHR, 0.50 for completion thyroidectomy; aHR, 1.08 for total thyroidectomy; P=.75) and RAI (aHR, 1.41; P=.42) were not associated with DSS in adjusted analysis.

Study design

  • 3214 patients aged ≥66 years with clinical T1N0M0 PTC were analyzed for treatment modality and associated DSS outcomes.
  • Funding: NIH.

Limitations

  • Retrospective study of large database.