Thyroid Lobectomy for Unilateral Papillary Thyroid Carcinoma Patients With High-Volume ( n ≥ 5) Central Lymph Node Metastases.

Abstract

This study aimed to evaluate whether the extent of thyroidectomy is associated with long-term prognosis in patients with unilateral papillary thyroid carcinoma (PTC) and high-volume (n ≥ 5) central lymph node metastases (CLNM). This study retrospectively analyzed the clinicopathological data of patients with unilateral PTC and high-volume (n ≥ 5) CLNM who underwent thyroidectomy between January 2013 and December 2019. Patients were divided into the thyroid lobectomy (TL) group and the total thyroidectomy (TT) group based on the extent of thyroidectomy. The primary outcome was recurrence-free survival (RFS), and the secondary outcome was the incidence of postoperative complications. A total of 192 patients were included in this study. Among them, 101 patients underwent TL, whereas 91 patients underwent TT. The median follow-up duration was 60 months. During the follow-up period, 5 cases of local recurrence were observed among 192 patients. The 5-year RFS was 97.1% in the TL group and 98.8% in the TT group. The log-rank test showed no significant difference in RFS between the two groups (p = 0.672). However, the TT group had higher rates of transient hypoparathyroidism. TL does not impact the long-term prognosis in unilateral PTC patients with high-volume (n ≥ 5) CLNM. Age ≥ 55 is associated with a higher risk of structure recurrence. For these patients who initially undergo TL, immediate completion thyroidectomy may not be necessary.