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Minimally invasive video-assisted thyroidectomy for papillary thyroid cancer: a prospective 5-year follow-up study

Abstract

Background

Minimally invasive video-assisted thyroidectomy (MIVAT) was initially introduced for the treatment of selected patients who met certain thyroid volume, nodule size and pathological criteria. Recent studies indicate that the completeness of resection of malignant nodules is comparable to that obtained with conventional thyroidectomy.

Aims

To compare the 5-year outcomes in patients with papillary thyroid carcinoma (PTC) treated with MIVAT versus conventional thyroidectomy.

Methods

In this prospective cohort study conducted over 2 years (July 2005-June 2007), 172 patients with node-negative, nonmetastatic PTC underwent either MIVAT (n = 67) or conventional thyroidectomy (n = 105). Study outcomes were 1) the cumulative dose of radioactive iodine (RAI) to achieve a disease-free state, defined as a stimulated serum thyroglobulin (Tg) level <2 ng/mL with negative Tg antibody and no tumor on a whole-body scan or cross-sectional imaging, and 2) the 5-year serum Tg level.

Results

The clinical parameters of the MIVAT and conventional thyroidectomy groups were comparable except for age (mean 43 ± 12 vs. 59 ± 17 years, respectively; p = 0.03) and operative time (mean 69 ± 24 vs. 53 ± 16 minutes, p = 0.02); the mean tumor size was similar between groups (1.3 ± 0.7 vs. 1.6 ± 0.9 cm, p = 0.14). Surgical morbidity was similar in both groups. Median follow-up was 5 years. RAI dose (mean 72 ± 38 vs. 96 ± 47 mCu, p = 0.34) and serum Tg at 5 years (mean 0.3 ± 0.2 vs. 0.5 ± 0.3 ng/mL, p = 0.30) were not significantly different between the MIVAT and conventional thyroidectomy groups.

Conclusions

MIVAT can be safely utilized in patients with localized PTC, providing comparable completeness of resection and oncological outcome to conventional thyroidectomy.

Tumori 2015; 101(2): 144 - 147

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000223

Authors

Paolo Del Rio, Umberto Maestroni, Mario Sianesi, Lorenzo Viani, Diego Vicente, Alexander Stojadinovic, Itzhak Avital

Article History

Disclosures

Financial support: None.
Conflict of interest: None.
Copyright protection: Some of the contributing authors are military service members (or employees of the U.S. Government: AS), and this work was prepared as part of their official duties. Title 17 U.S.C. 105 provides the “Copyright protection under this title is not available for any work of the United States Government.” Title 17 U.S.C. 101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties.
Disclaimer: The views expressed in this manuscript are those of the authors and do not reflect the official policy of the Department of the Army, the Department of Defense, or the United States Government.

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Authors

Affiliations

  • Department of Surgery, University Hospital of Parma, Parma - Italy
  • Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD - USA
  • United States Military Cancer Institute, Bethesda, MD - USA
  • Uniformed Services University of the Health Sciences, Bethesda, MD - USA
  • Bon Secours Cancer Institute, Richmond, VA - USA

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