title: Quality indicators for thyroid cancer surgery: current perspective.
abstract: BACKGROUND
  While the disease specific mortality of differentiated thyroid cancer has remained low with current treatments, its incidence has been steadily rising over the past several decades, and cancer related recurrence and morbidity have remained a significant problem. Quality indicators currently employed are relevant to the surgical intervention, but do not necessarily reflect oncological outcomes. Therefore, thyroid cancer specific surgical quality indicators, that offer insight into risk of cancer related morbidity and mortality are needed.
  
  
  METHODS
  This review aims to discuss the role of measuring quality in thyroid surgical oncology and carry out a comprehensive review of potential quality indicators for thyroid cancer operations. The three quality indicators reviewed here are the postoperative radioactive iodine update by remnant thyroid tissue, the proportion of resected lymph nodes with evidence of metastases, and the post-operative serum thyroglobulin level. Expert commentary: Together, these quality indicators may be utilized to guide improvement of the quality of surgical care for this unique patient population. A critical future step in establishing the role of quality indicators for thyroid cancer surgery is the determination of cutoff values of each indicator in an evidence-based manner.
authors: a Department of Surgery , St. Paul's Hospital and University of British Columbia , Vancouver , British Columbia, Canada.
authors: Rachel Q
authors: RQ
authors: Liu
authors: a Department of Surgery , St. Paul's Hospital and University of British Columbia , Vancouver , British Columbia, Canada.
authors: Sam M
authors: SM
authors: Wiseman
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local; D019984:Quality Indicators, Health Care; D013954:Thyroglobulin / Q000097:blood; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*
chemical_list: D007457:Iodine Radioisotopes; D013954:Thyroglobulin
keywords: Quality indicators; differentiated thyroid cancer; metastatic lymph node ratio; papillary carcinoma; remnant tissue uptake of radioactive iodine; thyroglobulin