Open Access
07-12-2024 | Thyroidectomy | Endocrine Tumors
Feasibility of Lobectomy in Selected Patients with Unilateral N1b Papillary Thyroid Cancer
Authors:
Danxia Li, MD, PHD, Guojun Zhang, MD, Xinna Li, MD, PHD, Shuo Xu, MD, Haiqing Sun, MD, Yang Liu, MD, Guochang Wu, MD, Haitao Zheng, MD, PHD, Xiaoli Zhang, BM, Guibin Zheng, MD, PHD
Published in:
Annals of Surgical Oncology
|
Issue 4/2025
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Abstract
Background
Total thyroidectomy (TT) is usually recommended for unilateral papillary thyroid cancer (PTC) with lateral lymph node metastasis (LLNM), but no significant improvement in recurrence-free survival (RFS) is seen upon treatment. As an initial surgery, lobectomy may have advantages in appropriately selected unilateral PTC with ipsilateral LLNM.
Objective
This study aimed to explore the feasibility of lobectomy for selected unilateral PTC with ipsilateral LLNM.
Methods
From January 2014 to December 2021, we retrospectively reviewed patients with PTC and LLNM who were treated at our center. Patients preoperatively diagnosed with unilateral PTC and ipsilateral LLNM were recruited. Overall, 102 patients who chose lobectomy as their initial surgery were included in the lobectomy group and 96 patients who chose TT were included in the control group, defined as the TT group.
Results
The mean follow-up time of the lobectomy group was 47.5 ± 22.2 months. Patients in the lobectomy group had a significantly lower rate of hypoparathyroidism than those in the TT group (0% vs. 11.5%; p < 0.001). RFS after lobectomy was comparable with that after TT according to Kaplan–Meier curve analysis (log-rank p = 0.80). Lobectomy achieved a significantly lower incidence of unsatisfactory TSH control than TT (5.9% vs. 20.8%; p = 0.006).
Conclusions
Lobectomy may be an appropriate initial therapy for selected unilateral PTC with ipsilateral LLNM. A randomized prospective study with long-term follow-up is warranted.
