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World Journal of Surgery

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01-11-2015 | Original Scientific Report

Is There Justification for Total Thyroidectomy in Low-Risk Papillary Thyroid Carcinoma? A Decision-Analysis Model

Authors: Sagit Stern, Ohad Hilly, Einav Horowitz, Moshe Leshno, Raphael Feinmesser

Published in: World Journal of Surgery | Issue 11/2015

Abstract

Background

Low-risk papillary thyroid carcinoma is commonly treated surgically. However, uncertainties exist in regard to the optimal extent of surgery. We approached this question using a decision-analysis model.

Methods

A Markov model was used to compare outcome between patients with small (1–2 cm) low-risk PTC treated by hemithyroidectomy or total thyroidectomy. Probabilities and utilities were derived from the literature. The model was evaluated with Monte Carlo simulation. Sensitivity analysis was used to determine which variables most affected the model.

Results

Hemithyroidectomy was associated with a minor increase in mortality risk. After incorporation of mortality risk, complications, and quality-of-life measures, hemithyroidectomy was found to be superior to total thyroidectomy, with an increasing benefit over time. Quality-of-life measures, especially disutility of disease recurrence and undergoing surgery, had the greatest effect on the incremental benefit of hemithyroidectomy.

Conclusion

Based on our decision-analysis model, hemithyroidectomy is the preferred option in low-risk PTC.

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Title: Is There Justification for Total Thyroidectomy in Low-Risk Papillary Thyroid Carcinoma? A Decision-Analysis Model
Authors: Sagit Stern
Ohad Hilly
Einav Horowitz
Moshe Leshno
Raphael Feinmesser
Publication date: 01-11-2015
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 11/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-015-3167-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Is There Justification for Total Thyroidectomy in Low-Risk Papillary Thyroid Carcinoma? A Decision-Analysis Model

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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