Hemithyroidectomy for low-risk follicular carcinoma of thyroid: results from a regional hospital.

Hemithyroidectomy for low-risk follicular carcinoma of thyroid: results from a regional hospital.

Singapore Med J. 2017 Dec 07;:

Authors: Chow TL, Tam SW, Choi CY, Kwan WW

Abstract
INTRODUCTION: Excellent outcome after conservative thyroid surgery for low-risk follicular thyroid carcinoma (FTC) has been reported from highly specialised centres. However, it is uncertain whether similar treatment results can be achieved in low-volume hospitals.
METHODS: At our institution, 49 patients with FTC were treated during 1991-2014. Patients with minimally invasive FTC (MIFTC) were usually treated with hemithyroidectomy. The demographic data, pathology, treatment modality and oncological outcomes of these patients were retrospectively evaluated.
RESULTS: TNM classification of the tumours was stage I in 40.8%, stage II in 32.7%, stage III in 20.4% and stage IV in 6.1% of patients. Only 4 (8.2%) patients had widely invasive FTC (WIFTC). Vascular invasion or capsular invasion alone occurred in 9 (19.1%) and 19 (40.4%) patients, respectively, while 19 (40.4%) patients had simultaneous vascular and capsular invasions. 34 (69.4%) patients with MIFTC initially underwent hemithyroidectomy while 15 (30.6%) patients with WIFTC underwent total thyroidectomy. Ten patients who underwent total thyroidectomy received radioactive iodine ablation. The mean follow-up duration was 86.9 ± 56.6 months. There was no disease-specific mortality, although two patients with WIFTC remained alive with disease at the end of the study. The five-, ten- and 15-year overall survival rates were 95%, 91% and 84%, respectively. Five patients from the hemithyroidectomy group died due to other illnesses with no evidence of FTC.
CONCLUSION: Satisfactory disease control and excellent survival for MIFTC is achievable by hemithyroidectomy in community hospitals. Total thyroidectomy should be reserved for WIFTC or aggressive tumours with nodal or distant metastasis.

PMID: 29214321 [PubMed - as supplied by publisher]

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