Risk of Complications in Patients Undergoing Completion Thyroidectomy After Hemithyroidectomy for Thyroid Nodule with Indeterminate Cytology: An Italian Multicentre Retrospective Study

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2022 May 28

PMID 35626075

Authors

Gian Luigi Canu

Fabio Medas

Federico Cappellacci

Alessio Biagio Filippo Giordano

Angela Gurrado

Claudio Gambardella

Giovanni Docimo

Francesco Feroci

Giovanni Conzo

Mario Testini

Pietro Giorgio Calo

Affiliations

Soon will be listed here.

Abstract

There is still controversy as to whether patients undergoing a completion thyroidectomy after a hemithyroidectomy for a thyroid nodule with an indeterminate cytology have a comparable, increased or decreased risk of complications compared to those submitted to primary thyroid surgery. The main aim of this study was to investigate this topic. Patients undergoing a thyroidectomy for thyroid nodular disease with an indeterminate cytology in four high-volume thyroid surgery centres in Italy, between January 2017 and December 2020, were retrospectively analysed. Based on the surgical procedure performed, four groups were identified: the TT Group (total thyroidectomy), HT Group (hemithyroidectomy), CT Group (completion thyroidectomy) and HT + CT Group (hemithyroidectomy with subsequent completion thyroidectomy). A total of 751 patients were included. As for the initial surgery, 506 (67.38%) patients underwent a total thyroidectomy and 245 (32.62%) a hemithyroidectomy. Among all patients submitted to a hemithyroidectomy, 66 (26.94%) were subsequently submitted to a completion thyroidectomy. No statistically significant difference was found in terms of complications comparing both the TT Group with the HT + CT Group and the HT Group with the CT Group. The risk of complications in patients undergoing a completion thyroidectomy after a hemithyroidectomy for a thyroid nodule with an indeterminate cytology was comparable to that of patients submitted to primary thyroid surgery (both a total thyroidectomy and hemithyroidectomy).

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References

Conzo G, Avenia N, Ansaldo G, Calo P, De Palma M, Dobrinja C . Surgical treatment of thyroid follicular neoplasms: results of a retrospective analysis of a large clinical series. Endocrine. 2016; 55(2):530-538. DOI: 10.1007/s12020-016-0953-2. View

Papale F, Cafiero G, Grimaldi A, Marino G, Rosso F, Mian C . Galectin-3 expression in thyroid fine needle cytology (t-FNAC) uncertain cases: validation of molecular markers and technology innovation. J Cell Physiol. 2012; 228(5):968-74. DOI: 10.1002/jcp.24242. View

Dobrinja C, Samardzic N, Giudici F, Raffaelli M, De Crea C, Sessa L . Hemithyroidectomy versus total thyroidectomy in the intermediate-risk differentiated thyroid cancer: the Italian Societies of Endocrine Surgeons and Surgical Oncology Multicentric Study. Updates Surg. 2021; 73(5):1909-1921. DOI: 10.1007/s13304-021-01140-1. View

Sessa L, De Crea C, Zotta F, Cerviere M, Gallucci P, Pennestri F . Post-thyroidectomy hypocalcemia: Is a routine preferable over a selective supplementation?. Am J Surg. 2021; 223(6):1126-1131. DOI: 10.1016/j.amjsurg.2021.10.015. View

Rosato L, De Crea C, Bellantone R, Brandi M, De Toma G, Filetti S . Diagnostic, therapeutic and health-care management protocol in thyroid surgery: a position statement of the Italian Association of Endocrine Surgery Units (U.E.C. CLUB). J Endocrinol Invest. 2016; 39(8):939-53. DOI: 10.1007/s40618-016-0455-3. View

Calo P, Medas F, Conzo G, Podda F, Canu G, Gambardella C . Intraoperative neuromonitoring in thyroid surgery: Is the two-staged thyroidectomy justified?. Int J Surg. 2017; 41 Suppl 1:S13-S20. DOI: 10.1016/j.ijsu.2017.02.001. View

Bin Saleem R, Saleem M, Bin Saleem N . Impact of completion thyroidectomy timing on post-operative complications: a systematic review and meta-analysis. Gland Surg. 2018; 7(5):458-465. PMC: 6234247. DOI: 10.21037/gs.2018.09.03. View

Medas F, Tuveri M, Canu G, Erdas E, Calo P . Complications after reoperative thyroid surgery: retrospective evaluation of 152 consecutive cases. Updates Surg. 2019; 71(4):705-710. DOI: 10.1007/s13304-019-00647-y. View

Sawant R, Hulse K, Sohrabi S, Yeo J, Pal K, Gibb F . The impact of completion thyroidectomy. Eur J Surg Oncol. 2019; 45(7):1171-1174. DOI: 10.1016/j.ejso.2019.03.018. View

10.

Prinzi N, Sorrenti S, Baldini E, De Vito C, Tuccilli C, Catania A . Association of thyroid diseases with primary extra-thyroidal malignancies in women: results of a cross-sectional study of 6,386 patients. PLoS One. 2015; 10(3):e0122958. PMC: 4380416. DOI: 10.1371/journal.pone.0122958. View

11.

Doran H, Wiseman S, Palazzo F, Chadwick D, Aspinall S . Post-thyroidectomy bleeding: analysis of risk factors from a national registry. Br J Surg. 2021; 108(7):851-857. DOI: 10.1093/bjs/znab015. View

12.

Bakkar S, Papavramidis T, Aljarrah Q, Materazzi G, Miccoli P . Energy-based devices in thyroid surgery-an overview. Gland Surg. 2020; 9(Suppl 1):S14-S17. PMC: 6995898. DOI: 10.21037/gs.2019.08.05. View

13.

Prete F, Sgaramella L, Di Meo G, Pasculli A, Calculli G, Protopapa G . Introducing routine intraoperative nerve monitoring in a high-volume endocrine surgery centre: a health technology assessment. Updates Surg. 2021; 73(6):2263-2273. DOI: 10.1007/s13304-021-01104-5. View

14.

Giordano D, Botti C, Piana S, Zini M, Frasoldati A, Lusetti F . Postoperative hypoparathyroidism after completion thyroidectomy for well-differentiated thyroid cancer. Eur J Endocrinol. 2021; 185(3):413-419. DOI: 10.1530/EJE-21-0353. View

15.

Medas F, Erdas E, Gordini L, Conzo G, Gambardella C, Canu G . Risk of malignancy in thyroid nodules classified as TIR-3A: What therapy?. Int J Surg. 2017; 41 Suppl 1:S60-S64. DOI: 10.1016/j.ijsu.2017.03.056. View

16.

Li M, Dal Maso L, Vaccarella S . Global trends in thyroid cancer incidence and the impact of overdiagnosis. Lancet Diabetes Endocrinol. 2020; 8(6):468-470. DOI: 10.1016/S2213-8587(20)30115-7. View

17.

Baldini E, Tuccilli C, Prinzi N, Sorrenti S, Falvo L, De Vito C . Deregulated expression of Aurora kinases is not a prognostic biomarker in papillary thyroid cancer patients. PLoS One. 2015; 10(3):e0121514. PMC: 4373730. DOI: 10.1371/journal.pone.0121514. View

18.

Fresilli D, David E, Pacini P, Del Gaudio G, Dolcetti V, Lucarelli G . Thyroid Nodule Characterization: How to Assess the Malignancy Risk. Update of the Literature. Diagnostics (Basel). 2021; 11(8). PMC: 8391491. DOI: 10.3390/diagnostics11081374. View

19.

Nardi F, Basolo F, Crescenzi A, Fadda G, Frasoldati A, Orlandi F . Italian consensus for the classification and reporting of thyroid cytology. J Endocrinol Invest. 2014; 37(6):593-9. DOI: 10.1007/s40618-014-0062-0. View

20.

Lukinovic J, Bilic M . Overview of Thyroid Surgery Complications. Acta Clin Croat. 2021; 59(Suppl 1):81-86. PMC: 8212606. DOI: 10.20471/acc.2020.59.s1.10. View