Dr.Guttler’s patient thyroid Blog post #14:Surgery vs RFA for micro-thyroid cancers.

Dr.Guttler’s patient thyroid Blog post #14:Surgery vs RFA for micro-thyroid cancers.

Dr.Guttler’s comments:

  1. Surgery vs RFA for micro-thyroid cancers. RFA is the only treatment that dose not have a scar, surgical complications or the need to take thyroid hormone for life.
  2. There were significantly more patients with transient and permanent hypoparathyroidism in the TT than that in the lobectomy group (P < 0.001).
  3. No patients had permanent hypoparathyroidism after RFA.
  4. Lobectomy could be appropriate for most patients with PTMC when there is no evidence of extrathyroidal disease in the preoperative work-up.
  5. Preoperative and postoperative imaging studies are important for patients who undergo lobectomy or RFA for PTMC, because most recurrences are in the contralateral lobe.
  6. Thyroid RFA is becoming the procedure of choice for low risk micro-papillary cancer.
  7. RFA is better than lobectomy because of hospital complications, neck scar, thyroid hormone treatment post op and cost.
  8. Both RFA and lobectomy leaves either the whole thyroid in the case of RFA and half in the lobectomy case.
  9. RFA post therapy can follow the thyroid gland with imaging of the whole thyroid gland as well as the imaging followup of the remaining lobe in a lobectomy with much less possible quality of life issues.
  10. See me before the surgery for an evaluation if Thyroid RFA is right for you.
  11. 1310393-8860 or email to thyroid.manager@thyroid.com.
  12. Ask for Alicia
  13. Dr.G.

A comparison of lobectomy and total
thyroidectomy in patients with papillary
thyroid microcarcinoma: a retrospective
individual risk factor-matched cohort study
Hyemi Kwon et al
Abstract
Objective: Papillary thyroid microcarcinoma (PTMC) accounts for most of the increase in thyroid cancer in recent
decades. We compared clinical outcomes and surgical complications of lobectomy and total thyroidectomy (TT) in
PTMC patients.
Design and methods: In this retrospective individual risk factor-matched cohort study, 2031 patients with PTMC were
initially included. Patients who underwent lobectomy or TT were one-to-one matched according to individual risk
factors, including age, sex, primary tumor size, extrathyroidal extension, multifocality and cervical lymph node (LN)
metastasis.
Results: In total, 688 patients were assigned to each group. During the median 8.5 years of follow-up, 26 patients
(3.8%) in the lobectomy group and 11 patients (1.6%) in the TT group had recurrences. The relative risk of recurrence
was significantly less in the TT than that in the lobectomy group (hazard ratio (HR) 0.41; 95% confidence interval
(CI) 0.21–0.81; P = 0.01). Most recurrences (84.6%) in the lobectomy group occurred in the contralateral lobe, and all
patients were disease-free after completion of thyroidectomy. There were no significant differences in recurrence-
free survival between the two groups after exclusion of contralateral lobe recurrences (HR, 2.75; 95% CI, 0.08–8.79;
P = 0.08). There were significantly more patients with transient and permanent hypoparathyroidism in the TT than that
in the lobectomy group (P < 0.001).

Conclusions: Lobectomy could be appropriate for most patients with PTMC when there is no evidence of
extrathyroidal disease in the preoperative work-up. Preoperative and postoperative imaging studies are important for
patients who undergo lobectomy for PTMC, because most recurrences are in the contralateral lobe

Add Your Comment