Histologic parameters driving completion thyroidectomy for papillary thyroid carcinoma in a high-volume institution: A retrospective observational study

Leonardo Rossi; Andrea De Palma; Carlo Enrico Ambrosini; Lorenzo Fregoli; Antonio Matrone; Rossella Elisei; Gabriele Materazzi

doi:10.1016/j.amjsurg.2024.116016

Histologic parameters driving completion thyroidectomy for papillary thyroid carcinoma in a high-volume institution: A retrospective observational study

Am J Surg. 2024 Oct 15:239:116016. doi: 10.1016/j.amjsurg.2024.116016. Online ahead of print.

Authors

Leonardo Rossi¹, Andrea De Palma², Carlo Enrico Ambrosini³, Lorenzo Fregoli⁴, Antonio Matrone⁵, Rossella Elisei⁶, Gabriele Materazzi⁷

Affiliations

¹ Endocrine Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy. Electronic address: [email protected].
² Endocrine Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy. Electronic address: [email protected].
³ Endocrine Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy. Electronic address: [email protected].
⁴ Endocrine Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy. Electronic address: [email protected].
⁵ Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. Electronic address: [email protected].
⁶ Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. Electronic address: [email protected].
⁷ Endocrine Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy. Electronic address: [email protected].

PMID: 39437675
DOI: 10.1016/j.amjsurg.2024.116016

Abstract

Background: When the histological examination indicates papillary thyroid carcinoma (PTC), there is no unanimity on the need to proceed with completion thyroidectomy (CT). This study aims to assess the histologic parameters that influenced the decision to perform CT.

Materials and methods: This study included PTC patients who underwent thyroid lobectomy between 2019 and 2022. Group A included patients who underwent thyroid lobectomy without further treatments, whereas Group B included those who underwent CT based on histological findings. Differences in terms of histologic parameters were analyzed.

Results: Group A included 291 patients (68.3 %), whereas Group B 135 patients (31.7 %). Multivariate analysis identified associations between CT and tumor size (p < 0.001), aggressive variant (p = 0.009), and vascular invasion (p < 0.001). ROC curve analysis established a tumor size cut-off of 21 mm for CT. At ROC curve analysis, the cut-off number of aggressive factors required for CT was 2.

Conclusion: A thorough comprehensive assessment encompassing all pathological characteristics might be necessary in case of PTC with aggressive histologic features after thyroid lobectomy.

Keywords: Completion Thyroidectomy; Papillary thyroid carcinoma; Tailored surgery; Thyroid lobectomy.