Lobectomy versus total thyroidectomy in differentiated thyroid carcinoma: A review

Our aim was to test the efficacy of 131-I therapy (RIT) using recombinant human TSH (rhTSH) in patients with differentiated thyroid carcinoma (DTC) in whom endogenous TSH stimulation was not an option due to the poor patient's physical condition or due to the disease progression during L-thyroxin withdrawal. The study comprised 18 patients, who already have undergone total or near-total thyroidectomy and radioiodine ablation and 0–12 (median 5) RITs after L-thyroxin withdrawal. Our patients received altogether 44 RITs using rhTSH while on L-thyroxin. Six to 12 months after the first rhTSH-aided RIT, PR and SD was achieved in 3/18 (17%) and 4/18 patients (22%), respectively. In most patients (n= 12; 61%) disease progressed despite rhTSH-aided RITs. As a conclusion, rhTSH-aided RIT proved to add some therapeutic benefit in 39% our patients with metastatic DTC, who otherwise could not be efficiently treated with RIT.

Download Full-text

Pediatric Differentiated Thyroid Carcinoma: Outcome in Response to Initial Treatment

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v24i2.44175 ◽

2019 ◽

Vol 24 (2) ◽

pp. 143-148

Author(s):

Md Mosleh Uddin ◽

Syed Farhan Ali Razib ◽

Kazi Shameemus Salam ◽

Mohd Abdus Sattar ◽

Belayat Hossain Siddiquee

Keyword(s):

Adverse Effects ◽

Thyroid Carcinoma ◽

Total Thyroidectomy ◽

Initial Treatment ◽

Differentiated Thyroid Carcinoma ◽

Good Prognosis ◽

Imaging Studies ◽

Patients Experience ◽

Longterm Outcome

Introduction: Though the differentiated thyroid carcinoma in children is a common pediatric endocrine malignancy, its prognosis is excellent with a proper initial treatment. Objectives: This is to evaluate the initial treatment patern for a good prognosis with longterm outcome in pediatric DTC patients. Methods: This study is a prospective one done in BSMMU during a period of 10 years in 52 post-operative pediatric DTC patients after excluding the follow-up missing patients. These patients are yet in a regular follow-up were outcome evaluated with clinical, pathological & imaging studies. Results: All the patients got initial treatment of total thyroidectomy. About half of the group had undergone neck dissection along with total thyroidectomy. Forty six patients had taken 131-I therapy. The survival is 100%. Conclusion: The life expectancy for children with DTC is excellent. However, many patients experience adverse effects from thyroid surgery, resulting in life long complications. Bangladesh J of Otorhinolaryngology; October 2018; 24(2): 143-148

Download Full-text

Total thyroidectomy for differentiated thyroid carcinoma: primary and secondary operations

European Journal of Surgical Oncology ◽

10.1016/s0748-7983(98)80007-3 ◽

1998 ◽

Vol 24 (4) ◽

pp. 283-287 ◽

Cited By ~ 10

Author(s):

Aydan Erolu ◽

Muttalip Ünal ◽

Hilmi Kocaolu

Keyword(s):

Thyroid Carcinoma ◽

Total Thyroidectomy ◽

Differentiated Thyroid Carcinoma ◽

Secondary Operations

Download Full-text

The Role of Prophylactic Central Neck Dissection in Differentiated Thyroid Carcinoma: Issues and Controversies

Journal of Oncology ◽

10.1155/2011/127929 ◽

2011 ◽

Vol 2011 ◽

pp. 1-12 ◽

Cited By ~ 7

Author(s):

Kai-Pun Wong ◽

Brian Hung-Hin Lang

Keyword(s):

Thyroid Carcinoma ◽

Total Thyroidectomy ◽

Neck Dissection ◽

Differentiated Thyroid Carcinoma ◽

Central Neck Dissection ◽

American Thyroid Association ◽

Central Neck ◽

Surgical Morbidity ◽

Prophylactic Central Neck Dissection ◽

Risk Patients

Prophylactic central neck dissection (pCND) in differentiated thyroid carcinoma (DTC) is one of the most controversial surgical subjects in recent times. To date, there is little evidence to support the practice of pCND in patients with DTC undergoing total thyroidectomy. Although the recently revised American Thyroid Association (ATA) guideline has clarified many inconsistencies regarding pCND and has recommended pCND in “high-risk” patients, many issues and controversies surrounding the subject of pCND in DTC remain. The recent literature has revealed an insignificant trend toward lower recurrence rate in patients with DTC who undergo total thyroidectomy and pCND than those who undergo total thyroidectomy alone. However, this was subjected to biases, and there are concerns whether pCND should be performed by all surgeons who manage DTC because of increased surgical morbodity. Performing a unilateral pCND may be better than a bilateral pCND given its lower surgical morbidity. Further studies in this controversial subject are much needed.

Download Full-text