scholarly journals Clinical outcomes after delayed thyroid surgery in patients with papillary thyroid microcarcinoma

2017 ◽  
Vol 177 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Min Ji Jeon ◽  
Won Gu Kim ◽  
Hyemi Kwon ◽  
Mijin Kim ◽  
Suyeon Park ◽  
...  
Keyword(s):  
Risk Factor ◽  
Clinical Outcomes ◽  
Tumor Size ◽  
Delay Period ◽  
Individual Risk ◽  
Papillary Thyroid ◽  
Individual Risk Factor ◽  
Persistent Disease ◽  
Thyroid Microcarcinoma

Objective Active surveillance is an option for patients with papillary thyroid microcarcinoma (PTMC). However, the long-term clinical outcomes after delayed surgery remain unclear. We compared the long-term clinical outcomes of PTMC patients according to the time interval between initial diagnosis and surgery. Design and methods In this individual risk factor-matched cohort study, PTMC patients were classified into three groups according to the delay period: ≤6 months, 6–12 months and >12 months. Patients were matched by age, sex, extent of surgery, initial tumor size as measured by ultrasonography (US), and by the presence of extrathyroidal extension, multifocal tumors and central cervical lymph node metastasis. We compared the dynamic risk stratification (DRS) and the development of structural persistent/recurrent disease of patients. Results A total of 2863 patients were assigned to three groups. Their mean age was 50 years, 81% were female and 66% underwent lobectomy. The mean tumor size at the initial US was 0.63 cm. There were no significant differences in clinicopathological characteristics between groups after individual risk factor matching. Comparison of the DRS revealed no significant difference according to the delay period (P = 0.07). During the median 4.8 years of follow-up, there were no significant differences in the development of structural recurrent/persistent disease (P = 0.34) and disease-free survival (P = 0.25) between groups. Conclusions In PTMC patients, delayed surgery was not associated with higher risk of structural recurrent/persistent disease compared to immediate surgery. These findings support the notion that surgical treatment can be safely delayed in patients with PTMC under close monitoring.

scholarly journals A comparison of lobectomy and total thyroidectomy in patients with papillary thyroid microcarcinoma: a retrospective individual risk factor-matched cohort study

2017 ◽  
Vol 176 (4) ◽  
pp. 371-378 ◽  
Author(s):  
Hyemi Kwon ◽  
Min Ji Jeon ◽  
Won Gu Kim ◽  
Suyeon Park ◽  
Mijin Kim ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Total Thyroidectomy ◽  
Papillary Thyroid Microcarcinoma ◽  
Individual Risk ◽  
Matched Cohort ◽  
Papillary Thyroid ◽  
Individual Risk Factor ◽  
Matched Cohort Study ◽  
Thyroid Microcarcinoma

Objective Papillary thyroid microcarcinoma (PTMC) accounts for most of the increase in thyroid cancer in recent decades. We compared clinical outcomes and surgical complications of lobectomy and total thyroidectomy (TT) in PTMC patients. Design and methods In this retrospective individual risk factor-matched cohort study, 2031 patients with PTMC were initially included. Patients who underwent lobectomy or TT were one-to-one matched according to individual risk factors, including age, sex, primary tumor size, extrathyroidal extension, multifocality and cervical lymph node (LN) metastasis. Results In total, 688 patients were assigned to each group. During the median 8.5 years of follow-up, 26 patients (3.8%) in the lobectomy group and 11 patients (1.6%) in the TT group had recurrences. The relative risk of recurrence was significantly less in the TT than that in the lobectomy group (hazard ratio (HR) 0.41; 95% confidence interval (CI) 0.21–0.81; P = 0.01). Most recurrences (84.6%) in the lobectomy group occurred in the contralateral lobe, and all patients were disease-free after completion of thyroidectomy. There were no significant differences in recurrence-free survival between the two groups after exclusion of contralateral lobe recurrences (HR, 2.75; 95% CI, 0.08–8.79; P = 0.08). There were significantly more patients with transient and permanent hypoparathyroidism in the TT than that in the lobectomy group (P < 0.001). Conclusions Lobectomy could be appropriate for most patients with PTMC when there is no evidence of extrathyroidal disease in the preoperative work-up. Preoperative and postoperative imaging studies are important for patients who undergo lobectomy for PTMC, because most recurrences are in the contralateral lobe.

scholarly journals A favorable tumor size to define papillary thyroid microcarcinoma: an analysis of 1176 consecutive cases

2018 ◽  
Vol Volume 10 ◽  
pp. 899-906 ◽  
Author(s):  
Yanping Gong ◽  
Genpeng Li ◽  
Jianyong Lei ◽  
Jiaying You ◽  
Ke Jiang ◽  
...  
Keyword(s):  
Tumor Size ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Thyroid Microcarcinoma

Incidental versus clinical diagnosis of papillary thyroid microcarcinoma. Long-term prognosis

2020 ◽  
Vol 67 (5) ◽  
pp. 317-325
Author(s):  
José Ruiz ◽  
Antonio Ríos ◽  
José Manuel Rodríguez ◽  
Miriam Paredes ◽  
Victor Soriano ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Papillary Thyroid Microcarcinoma ◽  
Papillary Thyroid ◽  
Thyroid Microcarcinoma ◽  
Long Term Prognosis

scholarly journals Long-Term Ultrasound Follow-Up of Thyroid Colloid Cysts

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Dong Wook Kim
Keyword(s):  
Gradual Increase ◽  
Acute Onset ◽  
Papillary Thyroid ◽  
Abrupt Increase ◽  
Interval Change ◽  
Thyroid Microcarcinoma ◽  
Colloid Cysts ◽  
Thyroid Colloid

Objective. This study aimed to assess the interval changes of thyroid colloid cysts (TCCs) by performing long-term ultrasound (US) follow-up examinations.Methods. From 2007 to 2008, 437 patients underwent a lobectomy for the treatment of papillary thyroid microcarcinoma. Among them, 268 patients underwent 4 or more postoperative US follow-ups after surgery. This study investigated the prevalence and interval changes of TCCs≥3 mm by using US follow-ups.Results. Among 268 patients, 35 (13.1%) had TCCs≥3 mm by a preoperative thyroid US, and 6 (2.2%) had newly detected TCCs at a US follow-up. Through long-term US follow-up, the interval changes for TCCs were classified as follows: no interval change (n=8), gradual increase (n=8), gradual decrease (n=5), positive fluctuation (n=3), negative fluctuation (n=6), disappearance (n=5), and new detection (n=6). None of the TCC cases had a TCC that was ≥10 mm at its largest diameter, and no patient complained of any relevant symptoms pertaining to the TCCs.Conclusions. In this study, TCCs demonstrated various interval changes, but no abrupt increase was found or acute onset of symptoms occurred.

Obesity is not an Independent Risk Factor for Adverse Perioperative and Long-Term Clinical Outcomes Following Open AAA Repair or EVAR

2011 ◽  
Vol 45 (7) ◽  
pp. 607-613 ◽  
Author(s):  
Brian Park ◽  
Phong Dargon ◽  
Christopher Binette ◽  
Bruna Babic ◽  
Tina Thomas ◽  
...  
Keyword(s):  
Risk Factor ◽  
Clinical Outcomes ◽  
Independent Risk Factor
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