Abstract:

Objective: In modern practice, there is an increasing recommendation for higher utilization of lobectomy in the management of papillary thyroid cancer (PTC). However, in this decision where the optimal balance of locoregional recurrence and complication burden should be achieved, there are still conflicting results in the literature. The aim of this study was to evaluate the effect of high-risk factors in the Turkish population with PTC on the decision of hypothetical lobectomy. Material and Methods: In this study, 96 PTC patients undergoing total thyroidectomy were retrospectively analyzed. Preoperative and postoperative evaluation differences and the impact of high-risk factors (tumor size, multifocality, extrathyroidal extension and central lymph node metastasis) on the decision for hypothetical lobectomy were investigated. Results: In all patients and lobectomy-eligible patients, postoperative evaluations of multifocality, contralateral multifocality, and central lymph node metastases were significantly higher than preoperative evaluations. Consequently, postoperative evaluation revealed that completion thyroidectomy would be required in 52.9% of 51 patients who were hypothetically suitable for lobectomy. Furthermore, comparisons of tumor size-based grouping in lobectomy and total thyroidectomy suitable patients showed similar high-risk factor distribution except for central lymph node metastasis for tumors <10 mm and contralateral multifocality between 11-20 mm. Conclusion: Completion thyroidectomy will be required in approximately half of the patients evaluated as suitable for lobectomy in the treatment of PTC in the Turkish population. In the treatment decision, in which many patient- and surgeon-related factors are influential, each patient should be considered separately.

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