Treatment efficacy between total thyroidectomy and lobectomy for patients with papillary thyroid microcarcinoma: A systemic review and meta-analysis

Abstract

Introduction: This systemic review and meta-analysis was to determine whether the recurrence and mortality rates in papillary thyroid microcarcinoma (PTMC) patients were lower when treated with total thyroidectomy (TT) compared to thyroid lobectomy (TL).

Methods: Using PubMed, Cochrane library and EMBASE databases, we conducted a meta-analysis to assess the clinical outcomes in patients with PTMC based on surgical mode. The relative risk (RR) and 95% confidence interval (CI) were calculated for this meta-analysis.

Results: A total of 11 cohort studies that comprised of 13,801 patients met the inclusion criteria for this systematic review and meta-analysis. Overall, low recurrence rates were observed in the TT group compared to the TL group (RR = 0.57, 95% CI = 0.35 to 0.94, P_{heterogeneity} = 0.002, I² = 65.2%), however, no significant differences were observed between the two surgical methods for mortality rates (RR = 0.84, 95% CI = 0.27 to 2.54, P_{heterogeneity} = 0.023, I² = 68.5%). For subgroup analysis based on country and sample size, no significant differences were observed between the two groups for recurrence rates.

Conclusion: Our meta-analysis indicates that patients who underwent thyroid lobectomy had an increased risk of recurrence but not mortality compared to patients who had total thyroidectomy for papillary thyroid microcarcinoma.

Keywords: Lobectomy; Meta-analysis; Papillary thyroid microcarcinoma; Systematic review; Total thyroidectomy.