Total thyroidectomy versus thyroid lobectomy for papillary thyroid cancer: Comparative analysis after propensity score matching: A multicenter study.
BACKGROUND
In patients with papillary thyroid carcinoma (PTC), the role of total thyroidectomy (TT) versus that of thyroid lobectomy (TL) has been controversial.


METHODS
This retrospective study was approved by our institutional review board, and the requirement to obtain informed consent was waived. In total, 173 patients with 1- to 5-cm stage cN0 and cM0 PTC tumors treated by curative surgery from 1994 to 2008 were evaluated. Clinicopathologic features and adverse events were compared between patients who underwent TT and those who underwent TL. After adjustment for differences in baseline clinicopathologic factors using propensity score matching, we compared recurrence-free survival (RFS) and OS.


RESULTS
TL was performed in 120 patients and TT in 53 patients. Patients who underwent TT were older; had larger tumors; more frequently had nodal metastasis, multifocal tumors, and extracapsular invasion; and more frequently underwent radioactive iodine ablation than patients who underwent TL. Hypocalcemia requiring medication and recurrent laryngeal nerve paralysis were more frequent in TT than TL. The 10-year RFS and OS of all patients were 93.3% and 96.7%, respectively. There was no significant difference in RFS (90.6% vs 93.0% in TT and TL groups, respectively) or OS (96.2% vs 96.9% in TT and TL groups, respectively) according to the extent of surgical resection after propensity score matching.


CONCLUSIONS
Equivalent prognoses were observed for patients with 1- to 5-cm stage cN0 and cM0 PTC tumors treated by TL or TT after propensity score matching. Adverse events occurred less frequently in patients who underwent TL than TT.
Departments of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan. Electronic address: skuba@nagasaki-u.ac.jp.
Sayaka
S
Kuba
Departments of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Kosho
K
Yamanouchi
Departments of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Naomi
N
Hayashida
Department of Surgery, National Hospital Nagasaki Medical Center, Nagasaki, Japan.
Shigeto
S
Maeda
Departments of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Toshiyuki
T
Adachi
Departments of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Chika
C
Sakimura
Departments of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Fusako
F
Kawakami
Departments of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Hiroshi
H
Yano
Departments of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Megumi
M
Matsumoto
Departments of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Ryota
R
Otsubo
Clinical Research Center, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Shuntaro
S
Sato
Department of Surgery, National Hospital Nagasaki Medical Center, Nagasaki, Japan.
Hikaru
H
Fujioka
Departments of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Tamotsu
T
Kuroki
Departments of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Takeshi
T
Nagayasu
Departments of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Susumu
S
Eguchi
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D011379:Prognosis; D057216:Propensity Score; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*
Adverse event; Overall survival; Papillary thyroid cancer; Recurrence free survival; Thyroid lobectomy; Total thyroidectomy