Oncologic Safety of Robot Thyroid Surgery for Papillary Thyroid Carcinoma: A Comparative Study of Robot versus Open Thyroid Surgery Using Inverse Probability of Treatment Weighting.
The aim of this study was to evaluate the oncologic safety of robot thyroid surgery compared to open thyroid surgery for papillary thyroid carcinoma (PTC). We enrolled 722 patients with PTC who underwent a total thyroidectomy with central compartment node dissection (CCND) from January 2009 to December 2010. These patients were classified into open thyroid surgery (n = 610) or robot thyroid surgery (n = 112) groups. We verified the impact of robot thyroid surgery on clinical recurrence and ablation/control-stimulated thyroglobulin (sTg) levels predictive of non-recurrence using weighted logistic regression models with inverse probability of treatment weighting (IPTW). Age, sex, thyroid weight, extent of CCND, and TNM were significantly different between the two groups (p < 0.05); however, there was no significant difference in recurrence between the open and robot groups (1.5% vs. 2.7%; p = 0.608). The proportion of patients with ablation sTg < 10.0 ng/mL and control sTg < 1.0 ng/mL was comparable between the two groups (p > 0.05). Logistic regression with IPTW using the propensity scores estimated by adjusting all of the parameters demonstrated that robot thyroid surgery did not influence the clinical recurrence (OR; 0.784, 95% CI; 0.150-3.403, p = 0.750), ablation sTg (OR; 0.950, 95% CI; 0.361-2.399, p = 0.914), and control sTg levels (OR; 0.498, 95% CI; 0.190-1.189, p = 0.130). Robot thyroid surgery is comparable to open thyroid surgery with regard to oncologic safety in PTC patients.
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Tae-Yon
TY
Sung
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Jong Ho
JH
Yoon
Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Minkyu
M
Han
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Yi Ho
YH
Lee
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Yu-Mi
YM
Lee
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Dong Eun
DE
Song
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ki-Wook
KW
Chung
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Won Bae
WB
Kim
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Young Kee
YK
Shong
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Suck Joon
SJ
Hong
D000328:Adult; D002277:Carcinoma / Q000097:blood / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008198:Lymph Nodes / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000209:etiology*; D011336:Probability; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D013954:Thyroglobulin / Q000097:blood; D000077273:Thyroid Cancer, Papillary; D013961:Thyroid Gland / Q000473:pathology / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*
D013954:Thyroglobulin