title: Low-risk papillary thyroid cancer recurrence in patients treated with total thyroidectomy and adjuvant therapy vs. patients treated with partial thyroidectomy.
abstract: BACKGROUND
  Surgical extension for treatment of patients with low-risk papillary thyroid carcinoma is still controversial. We undertook this study to assess if there is a difference in recurrence between patients undergoing total thyroidectomy plus adjuvant therapy and patients treated with only partial thyroidectomy.
  
  
  METHODS
  We conducted a longitudinal, observational, analytical study in patients with histopathological diagnosis of low-risk papillary thyroid carcinoma followed for at least 10 years. Patients were divided into two groups: Group 1: Patients treated with total thyroidectomy plus adjuvant therapy (TT) and Group 2: Patients treated with only partial thyroidectomy without adjuvant therapy (HT). Descriptive and inferential statistical methods were used.
  
  
  RESULTS
  AMES: 184 patients, recurrence in 5/23 HT and 7/161 TT (p = 0.0016); MACIS: 170 patients, recurrence in 5/24 HT and 5/146 TT (p = 0.0008); DeGroot: 92 patients, recurrence in 3/19 HT and 2/73 TT (p = 0.0254); TNM: 150 patients, recurrence in 5/22 HT and 7/128 TT (p = 0.0058). The time interval for local recurrences was higher in comparison to regional recurrences (p <0.05). In all classifications, recurrences occur mainly with regional metastatic disease (60%). Multifocality, bilateral disease and extracapsular disease showed no statistical difference. There was one incidental injury to a recurrent laryngeal nerve and this was repaired during the same surgical procedure. There was no morbidity due to hypoparathyroidism.
  
  
  CONCLUSIONS
  Patients classified as low risk according to any of the studied classifications have a higher risk for recurrence when treated with hemithyroidectomy than when treated with total thyroidectomy plus adjuvant therapy.
authors.affiliation: Unidad 307, Servicio de Cirugía General, Hospital General de México, Secretaría de Salud, México, D. F., Mexico. hurtado@clinicadetiroides.com.mx
authors.forename: Luis Mauricio
authors.initials: LM
authors.lastname: Hurtado-López
authors.forename: Javier
authors.initials: J
authors.lastname: Melchor-Ruan
authors.forename: Erich
authors.initials: E
authors.lastname: Basurto-Kuba
authors.forename: Edgar Rafael
authors.initials: ER
authors.lastname: Montes de Oca-Durán
authors.forename: Abraham
authors.initials: A
authors.lastname: Pulido-Cejudo
authors.forename: César
authors.initials: C
authors.lastname: Athié-Gutiérrez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000188:drug therapy / Q000453:epidemiology / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D061226:Recurrent Laryngeal Nerve Injuries; D012306:Risk; D013964:Thyroid Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000532:radiotherapy / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D013974:Thyroxine / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes; D013974:Thyroxine