Lobectomy vs total thyroidectomy for unilateral papillary thyroid carcinoma with ipsilateral cervical lymph node metastasis
ObjectiveThis study aimed to compare the prognosis of unilateral papillary thyroid carcinoma(PTC) patients with ipsilateral cervical lymph node metastasis(IC-LNM) under the treatment of unilateral lobectomy(uLT) vs total thyroidectomy(TT) in order to find out the optimal surgery for these patients w...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2025.1564752/full |
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| author | Shijia Zhang Shijia Zhang Kehui Zhou Kehui Zhou Jinyu Wang Ming Zhao Xiaochun Mao Jinbiao Shang Xiabin Lan Xiabin Lan |
| author_facet | Shijia Zhang Shijia Zhang Kehui Zhou Kehui Zhou Jinyu Wang Ming Zhao Xiaochun Mao Jinbiao Shang Xiabin Lan Xiabin Lan |
| author_sort | Shijia Zhang |
| collection | DOAJ |
| description | ObjectiveThis study aimed to compare the prognosis of unilateral papillary thyroid carcinoma(PTC) patients with ipsilateral cervical lymph node metastasis(IC-LNM) under the treatment of unilateral lobectomy(uLT) vs total thyroidectomy(TT) in order to find out the optimal surgery for these patients without other clinical risk characteristics.MethodsPTC patients at Zhejiang Cancer Hospital between 2012 and 2022 were retrospectively reviewed. Additionally, a propensity score matching(PSM) was performed on patients treated with uLT or TT. Recurrence-free survival(RFS), overall survival(OS), hospitalization costs, postoperative complications, and other clinical characteristics were analyzed between the two groups.ResultsUltimately, 682 unilateral PTC patients with IC-LNM were available in the study. After PSM with possible prognostic factors(such as gender, age, primary tumor size, multifocality, extrathyroidal invasion, and T-stage), 225 pairs of patients were available. With a median of 81(5-154) months follow-up, 22 patients(9.8%) in the uLT and 12(5.3%) in the TT recurred. There were no significant differences in 5-year RFS and 5-year OS between uLT and TT groups. However, TT group was significantly correlated with higher risk of transient and permanent hypoparathyroidism, higher levothyroxine doses, longer hospital stays, and higher hospitalization costs than uLT group(p<0.05).ConclusionsOur study indicated that there were no differences in recurrence and survival between unilateral PTC patients with IC-LNM treated with uLT or TT for the primary tumor. However, uLT group had a lower risk of postoperative complications and a lower hospitalization cost than TT group. Thus, for selected unilateral PTC patients with IC-LNM without other risk features, uLT could be recommended. |
| format | Article |
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| issn | 1664-2392 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Endocrinology |
| spelling | doaj-art-f0c4e10366724d7f95fccdda29b7f1b62025-07-24T04:10:31ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.15647521564752Lobectomy vs total thyroidectomy for unilateral papillary thyroid carcinoma with ipsilateral cervical lymph node metastasisShijia Zhang0Shijia Zhang1Kehui Zhou2Kehui Zhou3Jinyu Wang4Ming Zhao5Xiaochun Mao6Jinbiao Shang7Xiabin Lan8Xiabin Lan9Department of Thyroid Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang, ChinaPostgraduate Training Base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, ChinaDepartment of Thyroid Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang, ChinaPostgraduate Training Base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, ChinaDepartment of Medical Records and Statistics, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang, ChinaDepartment of Thyroid Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang, ChinaDepartment of Thyroid Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang, ChinaDepartment of Thyroid Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang, ChinaDepartment of Thyroid Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang, ChinaPostgraduate Training Base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, ChinaObjectiveThis study aimed to compare the prognosis of unilateral papillary thyroid carcinoma(PTC) patients with ipsilateral cervical lymph node metastasis(IC-LNM) under the treatment of unilateral lobectomy(uLT) vs total thyroidectomy(TT) in order to find out the optimal surgery for these patients without other clinical risk characteristics.MethodsPTC patients at Zhejiang Cancer Hospital between 2012 and 2022 were retrospectively reviewed. Additionally, a propensity score matching(PSM) was performed on patients treated with uLT or TT. Recurrence-free survival(RFS), overall survival(OS), hospitalization costs, postoperative complications, and other clinical characteristics were analyzed between the two groups.ResultsUltimately, 682 unilateral PTC patients with IC-LNM were available in the study. After PSM with possible prognostic factors(such as gender, age, primary tumor size, multifocality, extrathyroidal invasion, and T-stage), 225 pairs of patients were available. With a median of 81(5-154) months follow-up, 22 patients(9.8%) in the uLT and 12(5.3%) in the TT recurred. There were no significant differences in 5-year RFS and 5-year OS between uLT and TT groups. However, TT group was significantly correlated with higher risk of transient and permanent hypoparathyroidism, higher levothyroxine doses, longer hospital stays, and higher hospitalization costs than uLT group(p<0.05).ConclusionsOur study indicated that there were no differences in recurrence and survival between unilateral PTC patients with IC-LNM treated with uLT or TT for the primary tumor. However, uLT group had a lower risk of postoperative complications and a lower hospitalization cost than TT group. Thus, for selected unilateral PTC patients with IC-LNM without other risk features, uLT could be recommended.https://www.frontiersin.org/articles/10.3389/fendo.2025.1564752/fullunilateral lobectomytotal thyroidectomypapillary thyroid carcinomarecurrence-free survivalpropensity score matching |
| spellingShingle | Shijia Zhang Shijia Zhang Kehui Zhou Kehui Zhou Jinyu Wang Ming Zhao Xiaochun Mao Jinbiao Shang Xiabin Lan Xiabin Lan Lobectomy vs total thyroidectomy for unilateral papillary thyroid carcinoma with ipsilateral cervical lymph node metastasis Frontiers in Endocrinology unilateral lobectomy total thyroidectomy papillary thyroid carcinoma recurrence-free survival propensity score matching |
| title | Lobectomy vs total thyroidectomy for unilateral papillary thyroid carcinoma with ipsilateral cervical lymph node metastasis |
| title_full | Lobectomy vs total thyroidectomy for unilateral papillary thyroid carcinoma with ipsilateral cervical lymph node metastasis |
| title_fullStr | Lobectomy vs total thyroidectomy for unilateral papillary thyroid carcinoma with ipsilateral cervical lymph node metastasis |
| title_full_unstemmed | Lobectomy vs total thyroidectomy for unilateral papillary thyroid carcinoma with ipsilateral cervical lymph node metastasis |
| title_short | Lobectomy vs total thyroidectomy for unilateral papillary thyroid carcinoma with ipsilateral cervical lymph node metastasis |
| title_sort | lobectomy vs total thyroidectomy for unilateral papillary thyroid carcinoma with ipsilateral cervical lymph node metastasis |
| topic | unilateral lobectomy total thyroidectomy papillary thyroid carcinoma recurrence-free survival propensity score matching |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2025.1564752/full |
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