Open AccessThe Optimal Surgical Approach Selection for Papillary Thyroid Carcinoma With Pathological N1 Metastases: An Analyses on SEER Database
Author(s) -
J. Chen,
J Y Tai,
Tingting Ji,
Jianing Mou,
Xiaofeng Ni
Publication year - 2018
Publication title -
journal of global oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.002
H-Index - 17
ISSN - 2378-9506
DOI - 10.1200/jgo.18.92600
Subject(s) - medicine , thyroid carcinoma , proportional hazards model , total thyroidectomy , thyroidectomy , epidemiology , oncology , thyroid cancer , papillary carcinoma , carcinoma , cancer , pathological , thyroid , urology , gastroenterology
Background: The definition of large-volume pathologic N 1 metastases has been changed in the 2017 version of National Comprehensive Cancer Network (NCCN) guidelines, leading to a controversy over the optimal surgical approach selection for patients with papillary thyroid carcinoma (PTC). Aim: The aim of this study was to investigate the therapeutic efficacy of total thyroidectomy (TT) and thyroid lobectomy (TL) for these patients. Methods: In total 906 consecutive PTC patients with metastases ≤ 5 mm were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database, and divided into 2 groups (≤2 mm, >2 to 5 mm) based on the size of extend of disease (EOD). The overall survival (OS) was then compared between patients treated with TT and TL, followed by Cox-proportional hazards regression analysis to explore multiple prognostic factors. Results: OS favored TT compared with TL in patients with more than 5 involved nodes and metastases > 2 to 5 mm in largest dimension ( P 0.05). TT showed better survival than TL for patients with metastases > 2 mm to 5 mm. For patients with metastases ≤ 2 mm, either TT or TL should be recommended because of no discrepancy in survival. Conclusion: TT does offer slight survival advantage over TL for PTC patients with metastases > 2 mm to 5 mm; TT may be recommended for these patients to improve disease-special survival and reduce the risk of recurrence.