The Best Time for Completion Thyroidectomy on Differentiated Thyroid Carcinoma: A Literature Review

2020 ◽  
Author(s):  
Hyder O. Mirghani, MD, MSc
Keyword(s):  
Thyroid Carcinoma ◽  
English Language ◽  
Differentiated Thyroid Carcinoma ◽  
Completion Thyroidectomy ◽  
Inclusion Criteria ◽  
Timing Of Operation ◽  
Early Completion ◽  
Current Review ◽  
The Mean ◽  
Late Operation

Background: Completion thyroidectomy is performed for high-risk differentiated thyroid carcinoma; however, the timing of the completion thyroidectomy is a matter of controversy. The current review aimed to assess the best time for completion thyroidectomy in patients with differentiated thyroid carcinoma. Methods: An electronic search was conducted in various databases, such as Pub Med, Google Scholar, Scopus, and Medline, for relevant articles assessing the timing of completion thyroidectomy from the first published article to October 2019.  Keywords, “completion thyroidectomy” and “timing” were used. The search was limited to articles published in the English language. Among the 190 articles retrieved, only 11 fulfilled the inclusion criteria. Results: Of the 11 articles included, two were from Europe, one from Africa, one from Australia, and seven from Asia, and all were retrospective studies with the mean duration of studies being 12.71 ± 12.31 years.  Five studies (45.5%) showed no effect of timing on the outcomes, two (18.2%) recommended both early and late operation, another two (18.2%) concluded that late operation is better, one (9.1%) found that early surgery is better, while one study (9.1%) stated that the timing of operation should be based on the category of the patient. Conclusions: The results were mixed with some studies recommending late completion thyroidectomy, some observing that both early and late thyroidectomy are safe, while some finding no effect of time on the completion thyroidectomy. Well-designed controlled trials will resolve the issue. Keywords: early completion thyroidectomy, late thyroidectomy, timing

scholarly journals Immunocytochemistry Test of Protein BRAF Expression for Diagnosis of Well Differentiated Thyroid Carcinoma

2018 ◽  
Vol 11 (3) ◽  
pp. 843-849 ◽  
Author(s):  
I. Wayan Sudarsa ◽  
Elvis Deddy Kurniawan Pualillin ◽  
Putu Anda Tusta Adiputra ◽  
Ida Bagus Tjakra Wibawa Manuaba
Keyword(s):  
Positive Predictive Value ◽  
Thyroid Carcinoma ◽  
Negative Predictive Value ◽  
Diagnostic Test ◽  
Predictive Value ◽  
Preoperative Diagnosis ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Differentiated Thyroid Carcinoma ◽  
Inclusion Criteria

Background: Thyroid carcinoma generally has a good prognosis. The main focus of current research on thyroid carcinoma is to increase the accuracy of preoperative diagnosis of thyroid nodules. When the result of fine needle aspiration biopsy (FNAB) is indeterminate, clinicians often have doubts in determining the surgical management. Objective: Protein BRAF expression analysis can help improve the accuracy of FNAB and optimize the management of differentiated thyroid carcinoma. Methods: This study is a diagnostic test performed from October 2016 at Sanglah General Hospital with 38 patients as subjects who fulfilled the inclusion criteria. Data is being presented in descriptive form before diagnostic test is done to determine sensitivity, specificity, positive predictive value, negative predictive value and the accuracy of immunocytochemistry test for BRAF on indeterminate thyroid nodule. Results: Thirty-eight samples met the inclusion criteria during the study period. Three samples were male (7.9%) and 35 samples (92.1%) were female. The mean age of the sample was 45.21 years (SD ±10.910 years) with ages ranging from 23 to 66 years. Of the 12 samples undergoing isthmolobectomy, 7 samples (58.4%) were determined to be malignant from histopathological results. The sensitivity value of BRAF immunocytochemistry test is 45.45% with a specificity value of 81.25%, a positive predictive value of 76.92%, a negative predictive value of 52% and an accuracy of 60.50%. Analysis of the receiver operator (ROC) curve shows the area under the curve (AUC) of 63.4% with a confidence interval of 45.5–81.2%. Conclusion: Immunocytochemistry BRAF test have a reliable diagnostic value and can be taken into consideration in the preoperative diagnosis of thyroid malignancies.

scholarly journals Tc-99m radio-guided completion thyroidectomy for differentiated thyroid carcinoma

2010 ◽  
Vol 25 (1) ◽  
pp. 12 ◽  
Author(s):  
Oguzhan Karatepe ◽  
Omer Bender ◽  
Mehmet Mulazimoglu ◽  
Tevfik Ozpacaci ◽  
Ercan Uyanik ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Differentiated Thyroid Carcinoma ◽  
Completion Thyroidectomy

scholarly journals Parathyroid Changes After RAI in Patients With Differentiated Thyroid Carcinoma

2021 ◽  
Vol 12 ◽  
Author(s):  
Liu Xiao ◽  
Wenjie Zhang ◽  
Hongmei Zhu ◽  
Yueqi Wang ◽  
Bin Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thyroid Carcinoma ◽  
Serum Calcium ◽  
Multivariate Regression Analysis ◽  
Differentiated Thyroid Carcinoma ◽  
Thyroid Imaging ◽  
Before And After ◽  
Calcium Phosphorus ◽  
The Mean ◽  
Calcium And Phosphorus

ObjectiveThe purpose of this study was to investigate parathyroid hormone (PTH), serum calcium, phosphorus, and 25-hydroxyvitamin D (25-OH-VD) changes before and after radioactive iodine (RAI) in differentiated thyroid carcinoma (DTC) patients at different time points.MethodsA total of 259 DTC patients who received RAI were prospectively enrolled. We evaluated PTH, serum calcium, phosphorus, and 25-OH-VD levels at baseline pre-RAI, five days, six weeks, and six months post-RAI, respectively. We analyzed the risk factors of hypocalcemia at five days post-RAI.ResultsThe mean PTH, serum calcium and phosphorus values decreased five days post-RAI compared with pre-RAI (PTH 4.18 ± 1.23 pmol/L vs. 3.95 ± 1.41 pmol/L; calcium 2.27 ± 0.09 mmol/L vs. 2.20 ± 0.11 mmol/L; phosphorus 1.25 ± 0.17 vs. 0.98 ± 0.20 mmol/L, P < 0.05), and the differences were statistically significant. The mean 25-OH-VD levels did not significantly decrease at five days post-RAI. 21.2% (55/259) of patients had hypocalcemia at five days post-RAI, and all of them were given oral calcium supplements. At six weeks post-RAI, all of the above parameters were higher than those at five days post-RAI. Multivariate regression analysis showed that baseline pre-RAI serum calcium < 2.27 mmol/L, PTH < 4.18 pmol/L and negative 99mTcO4- thyroid imaging were risk factors for hypocalcemia at five days post-RAI.ConclusionFor DTC patients with normal PTH and serum calcium levels at pre-RAI, their PTH, serum calcium, and phosphorus levels decreased at five days post-RAI. About one-fifth of patients could have hypocalcemia at five days post-RAI. Lower baseline pre-RAI serum calcium and PTH levels and negative 99mTcO4- thyroid imaging were risk factors for hypocalcemia five days post-RAI.

Oncologic Outcomes After Completion Thyroidectomy for Patients with Well-Differentiated Thyroid Carcinoma

2013 ◽  
Vol 21 (4) ◽  
pp. 1374-1378 ◽  
Author(s):  
Brian R. Untch ◽  
Frank L. Palmer ◽  
Ian Ganly ◽  
Snehal G. Patel ◽  
R. Michael Tuttle ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Differentiated Thyroid Carcinoma ◽  
Oncologic Outcomes ◽  
Completion Thyroidectomy ◽  
Well Differentiated

scholarly journals The Difference in Thyroid Stimulating Hormone Levels between Differentiated Carcinoma and Benign Enlargement

2019 ◽  
Vol 24 (01) ◽  
pp. e73-e79
Author(s):  
Bambang Udji Djoko Rianto ◽  
Anton Sony Wibowo ◽  
Camelia Herdini
Keyword(s):  
Thyroid Carcinoma ◽  
Differentiated Thyroid Carcinoma ◽  
Thyroid Stimulating Hormone ◽  
Control Group ◽  
Case Group ◽  
Inclusion Criteria ◽  
The Difference ◽  
Benign Thyroid ◽  
Tsh Levels ◽  
Stimulating Hormone

Abstract Introduction Papillary and follicular thyroid carcinoma are common head and neck cancers. This cancer expresses a thyroid stimulating hormone (TSH) receptor that plays a role as a cancer stimulant substance. This hormone has a diagnostic value in the management of thyroid carcinoma. Objective The present study aimed to determine the difference in TSH levels between differentiated thyroid carcinoma and benign thyroid enlargement. Methods The present research design was a case-control study. The subjects were patients with thyroid enlargement who underwent thyroidectomies at the Dr. Sardjito General Hospital, Yogyakarta, Indonesia. Thyroid stimulating hormone levels were measured before the thyroidectomies. The inclusion criteria for the case group were: 1) differentiated thyroid carcinoma, and 2) complete data; while the inclusion criteria for the control group were: 1) benign thyroid enlargement, and 2) complete data. The exclusion criteria for both groups were: 1) patients suffering from thyroid hormone disorders requiring therapy before thyroidectomy surgery, 2) patients receiving thyroid suppression therapy before the thyroidectomy was performed, and 3) patients suffering from severe chronic diseases such as renal insufficiency, and severe liver disease. Results There were 40 post-thyroidectomy case group patients and 40 post-thyroidectomy control group patients. There were statistically significant differences in TSH levels between the groups with differentiated thyroid carcinoma and benign thyroid enlargement (p = 0.001; odds ratio [OR] = 8.42; 95% confidence interval [CI]: 3.19–36.50). Conclusion Based on these results, it can be concluded that there were significant differences in TSH levels between the groups with differentiated thyroid carcinoma and benign thyroid enlargement.

Prophylactic Completion Thyroidectomy for Differentiated Thyroid Carcinoma: Prediction of Extrathyroidal Soft Tissue Infiltrates

Thyroid ◽  
2001 ◽  
Vol 11 (4) ◽  
pp. 381-384 ◽  
Author(s):  
Andreas Machens ◽  
Raoul Hinze ◽  
Christine Lautenschläger ◽  
Oliver Thomusch ◽  
Henning Dralle
Keyword(s):  
Soft Tissue ◽  
Thyroid Carcinoma ◽  
Differentiated Thyroid Carcinoma ◽  
Completion Thyroidectomy

Completion Thyroidectomy in the Management of Well-Differentiated Thyroid Carcinoma

1992 ◽  
Vol 107 (1) ◽  
pp. 63-68 ◽  
Author(s):  
Mark K. Wax ◽  
T. David R. Briant
Keyword(s):  
Thyroid Carcinoma ◽  
Frozen Section ◽  
Thyroid Tissue ◽  
Complete Recovery ◽  
Vocal Cord Palsy ◽  
Differentiated Thyroid Carcinoma ◽  
Safe Procedure ◽  
Completion Thyroidectomy ◽  
Frozen Section Diagnosis ◽  
Well Differentiated

Completion thyroidectomy is the removal of any thyroid tissue that remains after less than total thyroidectomy. At our center, completion thyroidectomy is used when, on permanent sectioning, a frozen section diagnosis is revised from benign to malignant. We reviewed our experience with completion thyroidectomy to examine its indications and complications. We found that the carcinoma was misdiagnosed in 32 of 244 (13%) of cases. Twenty-five of these were initially designated follicular adenomas. The completion proved to be no more technically difficult than a routine hemithyroidectomy. There was one case of permanent hypoparathyroidism (3%). Transient vocal cord palsy occurred in one patient (3%) and transient hypocalcemia occured in five patients (15%). Complete recovery occurred in all six of these patients. Focal areas of residual carcinoma were found in 8 of 32 (25%) of glands removed at completion. We found completion thyroidectomy to be a safe procedure with minimal morbidity. We recommend its use in those instances of well-differentiated thyroid carcinoma in which the frozen section diagnosis differs from the permanent section.

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