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CC BY-NC-ND 4.0 · World J Nucl Med 2019; 18(02): 171-175
DOI: 10.4103/wjnm.wjnm_70_18
Original Article

Is hemi-thyroidectomy adequate in low risk differentiated thyroid cancer?

Justin Benjamin
0   Department of Nuclear Medicine, Christian Medical College, Vellore, Tamil Nadu, India
,
Julie Hephzibah
0   Department of Nuclear Medicine, Christian Medical College, Vellore, Tamil Nadu, India
,
Anish Jacob Cherian
1   Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu, India
,
David Mathew
0   Department of Nuclear Medicine, Christian Medical College, Vellore, Tamil Nadu, India
,
Nylla Shanthly
0   Department of Nuclear Medicine, Christian Medical College, Vellore, Tamil Nadu, India
,
Regi Oommen
0   Department of Nuclear Medicine, Christian Medical College, Vellore, Tamil Nadu, India
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Abstract

In low-risk differentiated thyroid carcinoma (LRDTC), appropriate surgical procedure in terms of hemi/total thyroidectomy (TT) has been an area of debate. The aim was to determine whether in LRDTC patients, hemithyroidectomy would be an adequate treatment, determine incidence of disease in contralateral lobe and evaluate the effect of radioactive iodine ablation (RAIA). Retrospective study was done from 2008 to 2014 at a single institution. Preoperative ultrasound (USG) and histopathology reports of all LRDTC patients following total/completion thyroidectomy were recorded. Details of postthyroidectomy, thyroid whole body scan, and stimulated serum thyroglobulin (sTg) levels were also documented and results analyzed. A total of 114/562 patients met inclusion criteria. Of these, 25/114 (22%) underwent hemithyroidectomy followed by a completion thyroidectomy while remaining 89/114 (78%) underwent TT initially. Preoperative USG detected single-lobe involvement in 44 patients; however, among them, histopathology revealed bilateral lobe disease in 17 (38.6%). There was a significant fall of sTg level following RAIA as compared to that before RAIA in T1b-T2 (P = 0.009 and 0.012, respectively). Median follow-up was 2 years (range: 1–7 years) with no distant metastasis or deaths recorded till 2017, except for one local recurrence 4 years after RAIA. In conclusion, the role of TT in LRDTC patients is important as 46% of patients were found to have tumor in contralateral lobe as well. Significant fall in sTg levels following RAIA justifies RAIA of remnant lobe even in LRDTC (T > 1a). It facilitates early detection of recurrence when sTg alone is used for follow-up.

Keywords

Hemithyroidectomy - low-risk differentiated thyroid carcinoma - radioactive iodine ablation - stimulated thyroglobulin

Financial support and sponsorship

Nil.




Publication History

Received: 00 00 2019

Accepted: 00 00 2019

Article published online:
22 April 2022

© 2019. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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