Thyroid lobectomy is an effective option for unilateral benign nodular disease.
OBJECTIVE
The use of thyroid lobectomy in the treatment of unilateral, benign nodules is limited by the potential of nodular recurrence in the remaining lobe. This study aimed to assess the rate and clinical impact of nodular recurrence in the contralateral lobe after thyroid lobectomy and to identify predictive factors of recurrence.


METHODS
Single-centre retrospective study.


METHODS
Records of patients that underwent lobectomy for unilateral thyroid nodules between 1991 and 2010 were reviewed and 270 patients were included. Exclusion criteria were: presence of contralateral nodule(s) ≥5 mm on preoperative ultrasound, diagnosis of cancer necessitating completion thyroidectomy or pseudonodules. Recurrence was defined as the occurrence of nodule(s) ≥5 mm in the remaining lobe on at least one postoperative ultrasound. A set of clinical, imaging, histological and biochemical parameters was tested as predictors of recurrence using logistic regression.


RESULTS
After a median follow-up of 78 months (range, 12-277 months), the global recurrence rate was 42% and recurrence of nodules of a size ≥1 cm occurred in 19%. Reoperation rate was 1·1%. 90% of patients were treated postoperatively by levothyroxine. Median time to nodular recurrence was 4 years. Preoperative contralateral lobe volume and resected thyroid weight were identified as significant predictors of recurrence (P = 0·045 and P = 0·03 respectively).


CONCLUSIONS
Thyroid lobectomy is an effective therapeutic strategy for unilateral, benign nodules, resulting in a low rate of clinically relevant nodular relapse in a mildly iodine-deficient area. Patients with uninodular disease and a contralateral lobe of normal size are particularly good candidates for lobectomy.
Department of Endocrinology and Diabetes, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium. mytrivi@ulb.ac.be.
Maria
M
Lytrivi
Department of Endocrinology and Diabetes, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Aglaia
A
Kyrilli
Department of Endocrinology and Diabetes, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Agnès
A
Burniat
Department of Thoracic Surgery, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Maria
M
Ruiz Patino
Department of Thoracic Surgery, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Youri
Y
Sokolow
Department of Endocrinology and Diabetes, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Bernard
B
Corvilain
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016606:Thyroid Nodule / Q000601:surgery*; D013965:Thyroidectomy / Q000592:standards*; D013974:Thyroxine / Q000627:therapeutic use
D013974:Thyroxine