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J Thyroid Res. 2013;2013:398194. doi: 10.1155/2013/398194. Epub 2013 Dec 23.

Thyroid Lobectomy Is Associated with Excellent Clinical Outcomes in Properly Selected Differentiated Thyroid Cancer Patients with Primary Tumors Greater Than 1 cm.

Journal of thyroid research

Fernanda Vaisman, Denise Momesso, Daniel A Bulzico, Cencita H C N Pessoa, Manuel Domingos Gonçalves da Cruz, Fernando Dias, Rossana Corbo, Mario Vaisman, R Michael Tuttle

Affiliations

  1. Endocrinology Service, Universidade Federal do Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária Ilha do Fundão, 21941-913 Rio de Janeiro, RJ, Brazil ; Endocrinology Service, Instituto Nacional do Cancer, Praça da Cruz Vermelha 23, Centro, 20230-130 Rio de Janeiro, RJ, Brazil.
  2. Endocrinology Service, Universidade Federal do Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária Ilha do Fundão, 21941-913 Rio de Janeiro, RJ, Brazil.
  3. Endocrinology Service, Instituto Nacional do Cancer, Praça da Cruz Vermelha 23, Centro, 20230-130 Rio de Janeiro, RJ, Brazil.
  4. Surgery Service, Universidade Federal do Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária Ilha do Fundão, 21941-913 Rio de Janeiro, RJ, Brazil.
  5. Head and Neck Service, Instituto Nacional do Cancer, Praça da Cruz Vermelha 23, Centro, 20230-130 Rio de Janeiro, RJ, Brazil.
  6. Endocrinology Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.

PMID: 24455413 PMCID: PMC3884614 DOI: 10.1155/2013/398194

Abstract

Background and Objective. An individualized risk-based approach to the treatment of thyroid cancer is being extensively discussed in the recent literature. However, controversies about the ideal surgical approach remain an important issue with regard to the impact on prognosis and follow-up strategies. This study was designed to describe clinical outcomes in a cohort of low and intermediate risk thyroid cancer patients treated with thyroid lobectomy. Methods. Retrospective review of 70 patients who underwent lobectomy. Results. After a median follow-up of 11 years, 5 patients (5/70, 7.1%) recurred and 5 had a completion for benign lesions, while 60 patients (86%) continued to be observed without evidence for disease recurrence. Suspicious ultrasound findings were significantly more common in patients that had structural disease recurrence (100% versus 4.3%, P < 0.001). Furthermore, a rising suppressed Tg value over time was also associated with structural disease recurrence (80% versus 21.5%, P = 0.01). After additional therapy, 99% of the patients had no evidence of disease. Conclusions. Properly selected thyroid cancer patients can be treated with lobectomy with excellent clinical outcomes.

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