Efficacy of thyroid isthmusectomy and its outcomes in patients with single isthmic papillary thyroid carcinoma: a single-center observational study

Document Type : Original Article

Authors

1 Department of Surgical Oncology, Faculty of Medicine, Al-Azhar University, Cairo Egypt.

2 Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background; Despite the total thyroidectomy is recommended for isthmic papillary thyroid 
carcinoma (PTC), the gold standard surgery is not well-known. We aimed to investigate the 
efficacy of isthmusectomy and its outcomes in the treatment of isthmic PTC. Methods; All
patients with single isthmic PTC and underwent total thyroidectomy with or without central 
neck dissection (CND) were included in the study. Patients with cervical lymph node 
metastasis and neck extension or patients with their cancer in another place were omitted 
from the study. Included patients were subdivide into 3 groups; total thyroidectomy, 
lobectomy with isthmusectomy, and isthmusectomy. Clinical and pathologic data and surgical 
outcomes were collected. Results: Among the included 121 patients, 28 were males and 93 
were females. Total thyroidectomy, isthmusectomy, and lobectomy with isthmusectomy were 
conducted in 70 (57.8%), 11 (9.1%), and 40 (33.1%), patients, respectively. Patients with total 
thyroidectomy showed increased postoperative hypoparathyroidism than patients with 
lobectomy and isthmusectomy. On the other hand, there were no significant differences in the 
recurrence rate or the survival between the 3 groups. Conclusion; Total thyroid
isthmusectomy may be helpful in the surgical management of small single isthmic PTC. 
Further studies are needed to verify this result.

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