Thyroid Lobectomy for Treatment of Well Differentiated Thyroid Cancer Confined to One Lobe

Yoo Seok Kim; Kweon Cheon Kim

doi:10.16956/kjes.2013.13.2.83

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Kim and Kim: Thyroid Lobectomy for Treatment of Well Differentiated Thyroid Cancer Confined to One Lobe

Original Article

Korean J Endocrine Surg 2013;13(2):83-86.

Published online: 10 December 2013

DOI: https://doi.org/10.16956/kjes.2013.13.2.83

Thyroid Lobectomy for Treatment of Well Differentiated Thyroid Cancer Confined to One Lobe

Yoo Seok Kim, Kweon Cheon Kim

Department of Surgery, Chosun University College of Medicine, Gwangju, Korea

Correspondence: Kweon Cheon Kim Department of Surgery, Chosun University College of Medicine, Chosun University Hospital, Seoseok-dong, Dong-gu, Gwangju 501-717, Korea Tel: ＋82-62-220-3068 Fax: ＋82-62-228-3441 e-mail: mdkckim8@hanmail.net

Received 7 February 2013 Revised 6 May 2013 Accepted 16 May 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

There has been controversy of the lobectomy for well differentiated thyroid cancer (WDTC). Current guidelines recommend total thyroidectomy for the cancer over 1cm, despite previous report suggesting that the lobectomy provides similar excellent outcomes. The purpose of our study is to report our experience of WDTC treated by thyroid lobectomy.

Methods

We retrospectively analyzed 284 patients with WDTC treated by thyroid lobectomy at department of Surgery in Chosun University Hospital from January 2002 to December 2010. Overall survival (OS) and disease-free survival (DFS) were determined by the Kaplan-Meier method. Factors predictive of recurrence by univariate and multivariate analysis were determined using the χ² test and Cox proportional hazard model respectively.

Results

With a mean follow-up of 60.4 months, OS and RFS for all patients were 97.9% and 96.5% respectively. No patient died due to WDTC. Univariate analysis showed statistically significant differences in recurrence by tumor size (P=0.013) and presence of invasion (P=0.039). However, Multivariate analysis showed no significant difference in local recurrence.

Conclusion

Patients with WDTC confined to one lobe can be safely treated by lobectomy.

Keywords: Thyroid cancer, Thyroid lobectomy, Local recurrence

References

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Fig. 1.

Overall survival (OS) and disease-free survival (DFS).

Table 1.

Clinicopathologic characteristics

Characteristics (N=284)	Number of patients (%)
Age
＜45 yr	103 (36.3)
≥45 yr	181 (63.7)
Gender
Male	42 (14.8)
Female	242 (85.2)
Tumor size
＜6 mm	89 (31.3)
6∼10 mm	149 (52.5)
＞10 mm	46 (16.2)
Central node metastasis
Absent	215 (75.7)
Present	69 (24.3)
Invasion
Absent	271 (95.4)
Skeletal muscle invasion	1 (0.4)
Perithyroidal soft tissue invasion	8 (2.8)
Capsular invasion	3 (1.1)
Perineural invasion	1 (0.4)
Pathology
Papillary	257 (90.5)
Follicular	27 (9.5)

Table 2.

Univariate analysis of factors for recurrence

Factors	No recurrence	Recurrence	P value
Factors	n=274 n (%)	n=10 n (%)	P value
Age			.177
＜45 yr	97 (35.4)	6 (60.0)
≥45 yr	177 (64.6)	4 (40.0)
Gender			1.000
Male	41 (15.0)	1 (10)
Female	233 (85)	9 (90)
Tumor size			.013
＜6 mm	87 (31.8)	2 (20)
6∼10 mm	146 (53.3)	3 (30)
＞10 mm	41 (15)	5 (50)
Central node metastasis			.709
Absent	208 (75.9)	7 (70)
Present	66 (24.1)	3 (30)
Invasion			.039
Absent	263 (96)	8 (80)
Skeletal muscle invasion	1 (0.4)	0 (0)
Perithyroidal soft tissue invasion	7 (2.6)	1 (10)
Capsular invasion	2 (0.7)	1 (10)
Perineural invasion	1 (0.4)	0 (0)
Pathology			.244
Papillary	249 (90.9)	8 (80)
Follicular	25 (9.1)	2 (20)

Table 3.

Multivariate analysis of factors for recurrence

Factors	Patients n (%)	P value	RR (95% CI*)
Age		.090	0.313
			(0.082∼1.197)
＜45 yr	6 (60.0)
≥45 yr	4 (40.0)
Gender		.562	0.526
			(0.060∼4.617)
Male	1 (10)
Female	9 (90)
Tumor size		.063	2.531
			(0.952∼6.727)
＜6 mm	2 (20)
6∼10 mm	3 (30)
＞10 mm	5 (50)
Central node metastasis		.789	0.905
			(0.435∼1.883)
Absent	7 (70)
Present	3 (30)
Invasion		.261	1.449
			(0.759∼2.767)
Absent	8 (80)
Skeletal muscle invasion	n 0 (0)
Perithyroidal soft tissue invasion	1 (10)
Capsular invasion	1 (10)
Perineural invasion	0 (0)
Pathology		.305	1.541
			(0.305∼7.778)
Papillary	8 (80)
Follicular	2 (20)

RR = relative risk. *Confidence interval.

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