Abstract
Whether total thyroidectomy reduces the recurrence rate in patients with papillary thyroid microcarcinoma (PTMC) is currently controversy. Conclusions of sporadic, inconsistent, and mono-institutional studies need a meta-analysis to evaluate. 525 relevant studies were obtained from initial search on PubMed, 511 studies were excluded by inclusion and exclusion criteria. Eligible data were extracted from each included study. The Odds ratios (ORs) and 95% confidence interval (CI) were used to assess the difference in the recurrence rates between PTMC patients treated with total thyroidectomy and non-total thyroidectomy. OR and 95% CI were calculated using a fixed-effects or a random-effects model. The Q statistic was used to evaluate homogeneity and Beggs test was used to assess publication bias. 14 studies meeting the inclusion criteria were included in this meta-analysis. The over all recurrence rates of pooled patients with total thyroidectomy and non-total thyroidectomy were 2.83% and 2.84% respectively. Primary random-effects model analysis showed, no significant difference of recurrence rates existed between two operation modes (OR = 0.732, 95% CI: 0.444 - 1.208), while, high heterogeneity among studies was found, I-squared index (I2) = 40.2%. After remove one study with high heterogeneity, the OR of the pooled recurrence rates of the total thyroidectomy and the non-total thyroidectomy groups was 0.786 (95% CI: 0.363 - 1.701), further suggesting no significant difference of the recurrence rate exists between two operation modes. Our meta-analysis demonstrated postoperative recurrence of PTMC is not reduced by total thyroidectomy, non-total thyroidectomy is also a good choice to treat PTMC patients.
Highlights
Papillary thyroid cancer (PTC) is the most common type of thyroid cancer making up to -80% of all thyroid cancer cases [1]
Papillary thyroid microcarcinoma (PTMC) is a subgroup of PTC, which refers to the tumor diameter is or less than 1cm in PTC according to the World Health Organization definition [1]
Of the 16 studies, the “total thyroidectomy” of two studies was defined as total thyroidectomy and near total lobectomy, which did not meet our definition of total thyroidectomy and were excluded
Summary
Papillary thyroid cancer (PTC) is the most common type of thyroid cancer making up to -80% of all thyroid cancer cases [1]. The involved lymph nodes can be surgically removed along with the thyroid, most people diagnosed with PTMC will not die from it [2,3,4,5]. Some scholars believe that the prognosis of PTMC is good, there is still a risk of recurrence and metastasis. These scholars advocate total thyroidectomy, that is, lobectomy of whole thyroid, including right lobe, left lobe, pyramidal lobe and isthmus, and even central lymph node dissection when necessary [6,7,8,9,10].
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