title: Long-term oncologic outcome of robotic versus open total thyroidectomy in PTC: a case-matched retrospective study.
abstract: The role of the robot in thyroid surgery remains uncertain, and it is unclear whether robotic total thyroidectomy (R-TT) can be justified as a standard treatment for patients with thyroid cancer. This study compared the long-term operative results and oncologic outcomes of R-TT and conventional open TT (O-TT) after propensity score matching of the cohorts.
  
  
  
  This study retrospectively evaluated patients with papillary thyroid cancer (PTC) who underwent TT with central compartment node dissection (CCND) by a single surgeon in tertiary medical center. Of the 833 patients, 94 (11.3 %) were lost to follow-up. 245 (33.2 %) underwent R-TT, and 494 (66.8 %) underwent O-TT. The mean follow-up duration was 74 (range 61-91) months. Propensity score matching in age, gender, tumor size, extrathyroidal invasion, multiplicity, bilaterality, and TNM stage identified 206 pairs of patients. The long-term oncologic outcomes were assessed in the R-TT and O-TT groups before and after adjustment for baseline covariates.
  
  
  
  After adjustment for baseline covariates, serum thyroglobulin (Tg) (p = 0.746) and anti-thyroglobulin antibody (TgAb) (p = 0.394) concentrations were similar in the two groups 5 years after surgery. Nine patients experienced locoregional recurrence, six in the O-TT and three in the R-TT group, with all recurrences in regional LNs. Disease-free survival (DFS) was similar in the R-TT and O-TT groups before matching (p = 0.890) and after adjustment for baseline covariates (p = 0.882).
  
  
  
  This represents the first report of 5-year surgical outcomes in patients who underwent R-TT for thyroid cancer. Long-term oncologic quality was similar after R-TT and O-TT.
authors.affiliation: Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea.
authors.forename: Seul Gi
authors.initials: SG
authors.lastname: Lee
authors.affiliation: Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea.
authors.forename: Jandee
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea.
authors.forename: Min Jhi
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea.
authors.forename: Jung Bum
authors.initials: JB
authors.lastname: Choi
authors.affiliation: Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea.
authors.forename: Tae Hyung
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea.
authors.forename: Eun Jeong
authors.initials: EJ
authors.lastname: Ban
authors.affiliation: Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea.
authors.forename: Cho Rok
authors.initials: CR
authors.lastname: Lee
authors.affiliation: Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea.
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Kang
authors.affiliation: Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea.
authors.forename: Jong Ju
authors.initials: JJ
authors.lastname: Jeong
authors.affiliation: Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea.
authors.forename: Kee Hyun
authors.initials: KH
authors.lastname: Nam
authors.affiliation: Department of Internal Medicine, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Young Suk
authors.initials: YS
authors.lastname: Jo
authors.affiliation: Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea. woungyounc@yuhs.ac.
authors.forename: Woong Youn
authors.initials: WY
authors.lastname: Chung
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D057216:Propensity Score; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*
keywords: Case-matched study; Disease-free survival; Long-term oncologic outcome; Papillary thyroid cancer; Robotic thyroidectomy