Risk Factors That Influence Surgical Decision-Making for Patients with Low-Risk Differentiated Thyroid Cancer with Tumor Diameters of 1-4 cm

被引:22
|
作者
Wang, Xiangming [1 ]
Zhang, Chao [1 ]
Srivastava, Akanksha [2 ]
Yu, Wenbin [3 ]
Liu, Chuan [4 ]
Wei, Dongmin [5 ]
Li, Yuncheng [6 ]
Yang, Jianming [1 ]
机构
[1] Anhui Med Univ, Hosp 2, Dept Otolaryngol Head & Neck Surg, Hefei 230601, Peoples R China
[2] Univ Texas MD Anderson Canc Ctr, Dept Head & Neck Surg, Houston, TX 77030 USA
[3] Peking Univ, Canc Hosp & Inst, Key Lab Carcinogenesis & Translat Res, Dept Head & Neck Surg,Minist Educ Beijing, Beijing, Peoples R China
[4] Chongqing Med Univ, Affiliated Hosp 1, Dept Otorhinolaryngol, Chongqing, Peoples R China
[5] Shandong Univ, Qilu Hosp, Dept Otorhinolaryngol, Jinan, Shandong, Peoples R China
[6] Huazhong Univ Sci & Technol, Dept Otorhinolaryngol, Union Hosp, Tongji Med Coll, Wuhan 430022, Peoples R China
来源
CANCER MANAGEMENT AND RESEARCH | 2020年 / 12卷
关键词
differentiated thyroid cancer; cancer metastasis; operation type; factor analysis; LYMPH-NODE METASTASIS; CARCINOMA; SURGERY; RECURRENCE;
D O I
10.2147/CMAR.S268716
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: There are several controversies between thyroid lobectomy and total thyroidectomy for surgical management of low-risk differentiated thyroid cancer (DTC) with a tumor diameter of 1-4 cm. Patients and Methods: In this study, we explore the factors related to selection of type of surgical procedure for 103 low-risk DTC patients with a tumor diameter of 1-4 cm. Results: Among 103 low-risk DTC patients with tumor diameters of 1-4 cm, 43 patients underwent total thyroidectomy and 60 patients underwent thyroid lobectomy based on postoperative pathology. A ROC curve showed that the optimal diagnostic threshold for selecting surgical modality was a tumor diameter of 2.15 cm. For these low-risk DTC patients, the sensitivity and specificity for predicting thyroid lobectomy when tumor diameter <2.15 cm while total thyroidectomy when tumor diameter >= 2.15 cm are 46.5% and 78.3%, respectively. There were significant differences between the selection of type of surgical procedure in patient groups with 1) tumors with multiple foci group vs a single focus (P<0.05), and 2) tumor diameter of >= 2.15 cm vs <2.15 cm (P 0.05). There was no significant difference between gender and age groups (P 0.05). Multivariate analysis confirmed that tumors with multiple foci and diameter >= 2.15 cm were the primary risk factors for implementation of total thyroidectomy (P<0.05). Conclusion: The diameter and multifocal nature of low-risk DTC tumors are the primary factors related to preferred surgical modality. This study revealed that thyroid lobectomy is more applicable to patients with tumor diameter <2.15 cm and a single focus, whereas, total thyroidectomy was preferred in patients with tumor diameter >= 2.15 cm and/or multiple foci.
引用
收藏
页码:12423 / 12428
页数:6
相关论文
共 50 条
  • [21] Reply to: Radioiodine ablation necessary for patients with low-risk papillary thyroid carcinoma and tumor &gt; 4 cm?
    Marti, J. L.
    Morris, L. G. T.
    Ho, A. S.
    EJSO, 2017, 43 (09): : 1804 - 1804
  • [22] SURGICAL DECISION-MAKING AMONG PATIENTS AT HIGH RISK FOR COLORECTAL CANCER
    Goldsmith, Rachel
    Rini, Christine
    Jandorf, Lina
    Duplessi, Yira
    Itzkowitz, Steven H.
    ANNALS OF BEHAVIORAL MEDICINE, 2007, 33 : S86 - S86
  • [23] Impact on Overall Survival of Radioactive Iodine in Low-Risk Differentiated Thyroid Cancer Patients
    Schvartz, Claire
    Bonnetain, Franck
    Dabakuyo, Sandrine
    Gauthier, Melanie
    Cueff, Adele
    Fieffe, Sandrine
    Pochart, Jean-Marie
    Cochet, Inna
    Crevisy, Elodie
    Dalac, Audrey
    Papathanassiou, Dimitri
    Toubeau, Michel
    JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2012, 97 (05): : 1526 - 1535
  • [24] Radioiodine (131I) treatment decision-making for low- and intermediate-risk differentiated thyroid cancer
    Gao, Haiyan
    Huang, Jiyuan
    Dai, Qingjing
    Su, Juan
    ARCHIVES OF ENDOCRINOLOGY METABOLISM, 2023, 67 (02): : 197 - 205
  • [25] Factors affecting parametrial involvement in cervical cancer patients with tumor size ≤4 cm and selection of low-risk patient group
    Akilli, Huseyin
    Tohma, Yusuf Aytac
    Gunakan, Emre
    Kucukyildiz, Irem
    Tunc, Mehmet
    Haberal, Nihan Reyhan
    Ayhan, Ali
    JOURNAL OF THE TURKISH-GERMAN GYNECOLOGICAL ASSOCIATION, 2021, 22 (01) : 37 - 41
  • [26] A protocol for a Canadian prospective observational study of decision-making on active surveillance or surgery for low-risk papillary thyroid cancer
    Sawka, Anna M.
    Ghai, Sangeet
    Tomlinson, George
    Rotstein, Lorne
    Gilbert, Ralph
    Gullane, Patrick
    Pasternak, Jesse
    Brown, Dale
    de Almeida, John
    Irish, Jonathan
    Chepeha, Douglas
    Higgins, Kevin
    Monteiro, Eric
    Jones, Jennifer M.
    Gafni, Amiram
    Goldstein, David P.
    BMJ OPEN, 2018, 8 (04):
  • [27] A Prospective Mixed-Methods Study of Decision-Making on Surgery or Active Surveillance for Low-Risk Papillary Thyroid Cancer
    Sawka, Anna M.
    Ghai, Sangeet
    Yoannidis, Tom
    Rotstein, Lorne
    Gullane, Patrick J.
    Gilbert, Ralph W.
    Pasternak, Jesse D.
    Brown, Dale H.
    Eskander, Antoine
    de Almeida, John R.
    Irish, Jonathan C.
    Higgins, Kevin
    Enepekides, Danny J.
    Monteiro, Eric
    Banerjee, Avik
    Shah, Manish
    Gooden, Everton
    Zahedi, Afshan
    Korman, Mark
    Ezzat, Shereen
    Jones, Jennifer M.
    Rac, Valeria E.
    Tomlinson, George
    Stanimirovic, Aleksandra
    Gafni, Amiram
    Baxter, Nancy N.
    Goldstein, David P.
    THYROID, 2020, 30 (07) : 999 - 1007
  • [28] Decision-making processes among men with low-risk prostate cancer: A survey study
    Hoffman, Richard M.
    Van den Eeden, Stephen K.
    Davis, Kimberly M.
    Lobo, Tania
    Luta, George
    Shan, Jun
    Aaronson, David
    Penson, David F.
    Leimpeter, Amethyst D.
    Taylor, Kathryn L.
    PSYCHO-ONCOLOGY, 2018, 27 (01) : 325 - 332
  • [29] SCARED DECISION-MAKING: THE ROLE OF EMOTIONS IN SURGEON-PATIENT TREATMENT DECISIONS ABOUT LOW-RISK THYROID CANCER
    Saucke, Megan
    Rosser, Alexandra
    Roman, Benjamin
    Hay, Jennifer
    Voils, Corrine
    Pitt, Susan
    MEDICAL DECISION MAKING, 2021, 41 (04) : E133 - E134
  • [30] Thyroid Lobectomy for Low-Risk 1-4 CM Papillary Thyroid Cancer is not Associated with Increased Recurrence Rates in the Dutch Population with a Restricted Diagnostic Work-Up
    Lin, J. F.
    Schaap, P. M. Rodriguez
    Metman, M. J. H.
    van Dijkum, E. J. M. Nieveen
    Dickhoff, C.
    Links, T. P.
    Kruijff, S.
    Engelsman, A. F.
    WORLD JOURNAL OF SURGERY, 2023, 47 (05) : 1211 - 1218