Thyroid Lobectomy Is Associated with Excellent Clinical Outcomes in Properly Selected Differentiated Thyroid Cancer Patients with Primary Tumors Greater Than 1 cm.
Background and Objective. An individualized risk-based approach to the treatment of thyroid cancer is being extensively discussed in the recent literature. However, controversies about the ideal surgical approach remain an important issue with regard to the impact on prognosis and follow-up strategies. This study was designed to describe clinical outcomes in a cohort of low and intermediate risk thyroid cancer patients treated with thyroid lobectomy. Methods. Retrospective review of 70 patients who underwent lobectomy. Results. After a median follow-up of 11 years, 5 patients (5/70, 7.1%) recurred and 5 had a completion for benign lesions, while 60 patients (86%) continued to be observed without evidence for disease recurrence. Suspicious ultrasound findings were significantly more common in patients that had structural disease recurrence (100% versus 4.3%, P < 0.001). Furthermore, a rising suppressed Tg value over time was also associated with structural disease recurrence (80% versus 21.5%, P = 0.01). After additional therapy, 99% of the patients had no evidence of disease. Conclusions. Properly selected thyroid cancer patients can be treated with lobectomy with excellent clinical outcomes.
Endocrinology Service, Universidade Federal do Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária Ilha do Fundão, 21941-913 Rio de Janeiro, RJ, Brazil ; Endocrinology Service, Instituto Nacional do Cancer, Praça da Cruz Vermelha 23, Centro, 20230-130 Rio de Janeiro, RJ, Brazil.
Fernanda
F
Vaisman
Endocrinology Service, Universidade Federal do Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária Ilha do Fundão, 21941-913 Rio de Janeiro, RJ, Brazil.
Denise
D
Momesso
Endocrinology Service, Instituto Nacional do Cancer, Praça da Cruz Vermelha 23, Centro, 20230-130 Rio de Janeiro, RJ, Brazil.
Daniel A
DA
Bulzico
Endocrinology Service, Instituto Nacional do Cancer, Praça da Cruz Vermelha 23, Centro, 20230-130 Rio de Janeiro, RJ, Brazil.
Cencita H C N
CH
Pessoa
Surgery Service, Universidade Federal do Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária Ilha do Fundão, 21941-913 Rio de Janeiro, RJ, Brazil.
Manuel Domingos Gonçalves
MD
da Cruz
Head and Neck Service, Instituto Nacional do Cancer, Praça da Cruz Vermelha 23, Centro, 20230-130 Rio de Janeiro, RJ, Brazil.
Fernando
F
Dias
Endocrinology Service, Universidade Federal do Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária Ilha do Fundão, 21941-913 Rio de Janeiro, RJ, Brazil ; Endocrinology Service, Instituto Nacional do Cancer, Praça da Cruz Vermelha 23, Centro, 20230-130 Rio de Janeiro, RJ, Brazil.
Rossana
R
Corbo
Endocrinology Service, Universidade Federal do Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária Ilha do Fundão, 21941-913 Rio de Janeiro, RJ, Brazil.
Mario
M
Vaisman
Endocrinology Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
R Michael
RM
Tuttle