Clinical advantages of total thyroidectomy in treating unilateral multiple papillary thyroid microcarcinoma

Abstract

Objective The purpose of this study was to investigate the advantages of total thyroidectomy in the treatment of unilateral multiple papillary thyroid microcarcinoma (UMPTMC). Methods Retrospective analysis of 90 patients with UMPTMC who underwent first operation from September 2014 to September 2016. Of these, 53 underwent unilateral lobar thyroidectomy (HT). The other 37 cases underwent total thyroidectomy (TT). Pearson chi-square test, Student’s t test and Kaplan-Meier method were used to plot the survival curve, and logarithmic rank test was used to score the survival curve. Subsequently, Cox proportional hazard analysis was used to analyze disease-free survival (P<0.05). Results The total diameter of all tumors in the HT group was >10 mm more common than in the TT group (39.6% vs.18.9%; P=0.046); the positive rate of central lymph node metastasis was higher in the TT group than in the HT group (81.1% vs. 60.4%) ; P=0.046); the incidence of tumor recurrence in the HT group was higher than in the TT case (26.4% vs. 2.7%; P=0.007). Disease-free survival rates were 90.6% (48/53) and 73.6% (39/53) in the HT group at 6 months and 11 months, and 100% (37/37) and 91.9% (34/37) in the TT group, respectively. Disease-free survival was significantly shorter in the HT group than in the TT group (log-rank test P=0.0059). Univariate analysis of Cox’s proportional hazard analysis showed that men, all tumors with a total diameter > 10 mm and central lymph node metastasis were risk factors for recurrence in HT patients. Conclusion Total thyroidectomy for unilateral multiple UMPTMC patients can effectively reduce the recurrence rate of tumor and prolongs the disease-free survival period. Therefore, with the increase of recurrence risk, TT is more appropriate for the initial operation of UMPTMC, especially for male patients and patients with total tumor diameter greater than 10 mm. Key words: Carcinoma, papillary; Thyroid neoplasms; Thyroidectomy