TY - JOUR
T1 - Hemithyroidectomy versus total thyroidectomy for well differentiated T1–2 N0 thyroid cancer
T2 - systematic review and meta-analysis
AU - Rodriguez Schaap, P. M.
AU - Botti, M.
AU - Otten, R. H. J.
AU - Dreijerink, K. M. A.
AU - Nieveen van Dijkum, E. J. M.
AU - Bonjer, H. J.
AU - Engelsman, A. F.
AU - Dickhoff, C.
N1 - © 2020 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of British Journal of Surgery Society.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Background: Evidence for limiting the extent of surgery in patients with low-risk thyroid cancer is lacking. Methods: A systematic search was performed according to the PRISMA and MOOSE guidelines to assess the effect of total thyroidectomy (TT) with or without radioactive iodine (RAI) treatment versus hemithyroidectomy (HT) on recurrence and overall mortality in patients with differentiated (papillary or follicular) T1–2 N0 thyroid cancer. PubMed, Embase and Cochrane databases were searched, and two authors independently assessed the articles. Results: A total of ten eligible articles were identified. All were observational cohort series, representing a total of 23 134 patients, of which 17 699 were available for meta-analysis. Six studies included patients who had TT followed by RAI treatment. The pooled recurrence rate after TT ± RAI and HT was 2·3 and 2·8 per cent respectively (odds ratio (OR) 1·12, 95 per cent c.i. 0·82 to 1·53; P = 0·48). The pooled 20-year overall survival rate after TT ± RAI was 96·8 per cent, compared with 97·4 per cent for HT (OR 1·30, 0·71 to 2·37; P = 0·40). Overall, higher complication rates were found in the TT ± RAI group. Conclusion: Recurrence rates after HT for treatment of well differentiated T1–2 N0 thyroid cancer were similar to those after TT ± RAI, with a lower incidence of treatment-related complications.
AB - Background: Evidence for limiting the extent of surgery in patients with low-risk thyroid cancer is lacking. Methods: A systematic search was performed according to the PRISMA and MOOSE guidelines to assess the effect of total thyroidectomy (TT) with or without radioactive iodine (RAI) treatment versus hemithyroidectomy (HT) on recurrence and overall mortality in patients with differentiated (papillary or follicular) T1–2 N0 thyroid cancer. PubMed, Embase and Cochrane databases were searched, and two authors independently assessed the articles. Results: A total of ten eligible articles were identified. All were observational cohort series, representing a total of 23 134 patients, of which 17 699 were available for meta-analysis. Six studies included patients who had TT followed by RAI treatment. The pooled recurrence rate after TT ± RAI and HT was 2·3 and 2·8 per cent respectively (odds ratio (OR) 1·12, 95 per cent c.i. 0·82 to 1·53; P = 0·48). The pooled 20-year overall survival rate after TT ± RAI was 96·8 per cent, compared with 97·4 per cent for HT (OR 1·30, 0·71 to 2·37; P = 0·40). Overall, higher complication rates were found in the TT ± RAI group. Conclusion: Recurrence rates after HT for treatment of well differentiated T1–2 N0 thyroid cancer were similar to those after TT ± RAI, with a lower incidence of treatment-related complications.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85104608971&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/33022150
UR - http://www.scopus.com/inward/record.url?scp=85104608971&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/bjs5.50359
DO - https://doi.org/10.1002/bjs5.50359
M3 - Review article
C2 - 33022150
SN - 2474-9842
VL - 4
SP - 987
EP - 994
JO - BJS Open
JF - BJS Open
IS - 6
ER -