APA
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Toraih, E., Hussein, M. H., Jishu, J. A., Landau, M. B., Abdelmaksoud, A., Bashumeel, Y. Y., … Kandil, E. (2024). Initial versus Staged Thyroidectomy for Differentiated Thyroid Cancer: A Retrospective Multi-Dimensional Cohort Analysis of Effectiveness and Safety. Cancers.
Chicago/Turabian
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Toraih, E., Mohammad H. Hussein, Jessan A. Jishu, Madeleine B. Landau, A. Abdelmaksoud, Yaser Y Bashumeel, Mahmoud A. AbdAlnaeem, et al. “Initial versus Staged Thyroidectomy for Differentiated Thyroid Cancer: A Retrospective Multi-Dimensional Cohort Analysis of Effectiveness and Safety.” Cancers (2024).
MLA
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Toraih, E., et al. “Initial versus Staged Thyroidectomy for Differentiated Thyroid Cancer: A Retrospective Multi-Dimensional Cohort Analysis of Effectiveness and Safety.” Cancers, 2024.
BibTeX Click to copy
@article{e2024a,
title = {Initial versus Staged Thyroidectomy for Differentiated Thyroid Cancer: A Retrospective Multi-Dimensional Cohort Analysis of Effectiveness and Safety},
year = {2024},
journal = {Cancers},
author = {Toraih, E. and Hussein, Mohammad H. and Jishu, Jessan A. and Landau, Madeleine B. and Abdelmaksoud, A. and Bashumeel, Yaser Y and AbdAlnaeem, Mahmoud A. and Vutukuri, Rithvik and Robbie, Christine and Matzko, Chelsea and Linhuber, Joshua and Shama, M. and Noureldine, S. and Kandil, Emad}
}
Simple Summary The choice between total thyroidectomy and staged completion thyroidectomy for differentiated thyroid cancer remains debated. This study investigated the safety profiles and optimal timing of completion thyroidectomy by analyzing nearly 80,000 patients. The findings demonstrate that total thyroidectomy carries higher risks of temporary and permanent hypoparathyroidism compared to completion thyroidectomy. However, scheduling completion thyroidectomy within 1–6 months of the initial lobectomy can mitigate permanent complication rates. These results provide insights to guide personalized surgical decision-making for thyroid cancer patients. Abstract The optimal surgical approach for differentiated thyroid cancer remains controversial, with debate regarding the comparative risks of upfront total thyroidectomy versus staged completion thyroidectomy following the initial lobectomy. This study aimed to assess the complication rates associated with these two strategies and identify the optimal timing for completion thyroidectomy using a multi-dimensional analysis of four cohorts: an institutional series (n = 148), the National Surgical Quality Improvement Program (NSQIP) database (n = 39,992), the TriNetX repository (n > 30,000), and a pooled literature review (10 studies, n = 6015). Institutional data revealed higher overall complication rates with total thyroidectomy (18.3%) compared to completion thyroidectomy (6.8%), primarily due to increased temporary hypocalcemia (10% vs. 0%, p = 0.004). The NSQIP analysis demonstrated that total thyroidectomy was associated with a 72% increased risk of transient hypocalcemia (p < 0.001) and a 25% increased risk of permanent hypocalcemia (p < 0.001). TriNetX data confirmed these findings and identified obesity and concurrent neck dissection as risk factors for complications. A meta-analysis showed that total thyroidectomy increased the rates of transient (RR = 1.63) and permanent (RR = 1.23) hypocalcemia (p < 0.001). Institutional and TriNetX data suggested that performing completion thyroidectomy between 1 and 6 months after the initial lobectomy minimized permanent complication rates compared to delays beyond 6 months. In conclusion, for differentiated thyroid cancer, total thyroidectomy is associated with higher risks of transient and permanent hypocalcemia compared to staged completion thyroidectomy. However, performing completion thyroidectomy within 1–6 months of the initial lobectomy may mitigate the risk of permanent complications. These findings can inform personalized surgical decision-making for patients with differentiated thyroid cancer.