The Incidence of Postoperative Re-stratification for Recurrence in Well-differentiated Thyroid Cancer - A Single Tertiary Israeli Center Experience

Tel Aviv Sourasky Medical Center

Status: Completed

Conditions: Well Differentiated Thyroid Carcinoma; Papillary Thyroid Cancer

Treatments: Procedure: UNILATERAL THYROIDECTOMY

Study type: Observational

Funder types: Other

Identifiers

NCT04500925

TASMC-20-NC-TLV-704-16-CTIL

Details and patient eligibility

About

Background After diagnosing well-differentiated thyroid cancer (WDTC), careful assessment of the risk for disease-specific recurrence is essential for deciding between partial (low risk) and completion (high risk) thyroidectomies. Patients' preoperatively determined risk levels are re-stratified according to surgical and final histopathological findings. The American Thyroid Association 2015 guidelines suggest that patients with WDTC between 1-4 cm in size and without suspicious features may be suitable candidates for partial thyroidectomy. The incidence and clinical implications of high-risk features discovered postoperatively in patients with preoperatively determined low-risk WDTC have not been previously reported.

Methods All thyroidectomies performed between 2006-2018 in the Tel Aviv Sourasky Medical Center were included. Pre- and postoperative risk stratifications were performed, and the rate of completion thyroidectomy was determined. Patients with 1-4 cm WDTC without evidence of positive cervical lymph nodes, invasion to adjacent structures, or high-risk cytology were considered at low risk for disease-specific recurrence and therefore suitable for lobectomy.

Enrollment: 301 patients

Sex: All

Ages: 38 to 61 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• All patients who underwent thyroid surgery (partial and total) between 2006-2018 at Tel Aviv Sourasky Medical Center (TASMC) were included

Exclusion criteria

• Patients with evidence of cervical lymph node metastasis, other malignancies, adverse imaging features (i.e., extracapsular spread of thyroid malignancy, vocal cord paralysis or immobility in physical examination) were excluded from the study.

Trial design

301 participants in 2 patient groups

UPSCALED

Treatment:

Procedure: UNILATERAL THYROIDECTOMY

NOT UPSCALED

Treatment:

Procedure: UNILATERAL THYROIDECTOMY