Surgical treatment of low- and intermediate-risk papillary thyroid cancer with minimally invasive video-assisted thyroidectomy

J Clin Endocrinol Metab. 2009 May;94(5):1618-22. doi: 10.1210/jc.2008-1418. Epub 2009 Feb 17.

Abstract

Background: Minimally invasive video-assisted thyroidectomy (MIVAT) was introduced in the clinical practice to treat small benign thyroid nodules. This method has recently been demonstrated to produce the same completeness as a conventional thyroidectomy in patients with papillary thyroid cancer (PTC). The low number of treated cases and the limited follow-up of these patients represent the major limitations of these studies.

Objective: The aim of the study was to compare the outcome of two groups of PTC patients, one treated with MIVAT and the other with conventional thyroidectomy, after a median follow-up of 5 yr.

Study group: A total of 221 PTC patients were enrolled in this study according to the following criteria: 171 were treated with MIVAT (group A), and 50 were treated with conventional thyroidectomy (group B).

Results: The outcome and the cumulative (131)I activity administered to achieve curative status were compared. After a mean follow-up of 3.6 +/- 1.5 yr (range, 1-8 yr; median, 5 yr), no differences were found between group A and group B. A similar rate of permanent hypoparathyroidism and/or nerve cord palsy was found in both groups.

Conclusion: We demonstrated that PTC patients operated on with MIVAT had a good outcome after 5 yr. This was similar to the outcome of patients treated with conventional thyroidectomy and the same degree of exposure to (131)I. These results, together with the evidence of a similar degree of completeness and rate of complications between the two surgical techniques, show that MIVAT is a valid option to treat low- and intermediate-risk PTC patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Carcinoma, Papillary / pathology
  • Carcinoma, Papillary / radiotherapy
  • Carcinoma, Papillary / surgery*
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Hypoparathyroidism / epidemiology
  • Hypoparathyroidism / etiology
  • Iodine Radioisotopes / therapeutic use
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / adverse effects
  • Minimally Invasive Surgical Procedures / methods*
  • Paralysis / epidemiology
  • Paralysis / etiology
  • Postoperative Complications / epidemiology
  • Risk
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / radiotherapy
  • Thyroid Neoplasms / surgery*
  • Thyroidectomy / adverse effects
  • Thyroidectomy / methods*
  • Treatment Outcome
  • Video-Assisted Surgery / adverse effects
  • Video-Assisted Surgery / methods*
  • Young Adult

Substances

  • Iodine Radioisotopes