PMID- 32026467
OWN - NLM
STAT- MEDLINE
DCOM- 20201225
LR  - 20201225
IS  - 1365-2168 (Electronic)
IS  - 0007-1323 (Linking)
VI  - 107
IP  - 6
DP  - 2020 May
TI  - Recurrence following hemithyroidectomy in patients with low- and 
      intermediate-risk papillary thyroid carcinoma.
PG  - 687-694
LID - 10.1002/bjs.11430 [doi]
AB  - BACKGROUND: This study evaluated the incidence, patterns and risk factors for 
      recurrence after hemithyroidectomy in patients with low- and intermediate-risk 
      papillary thyroid carcinoma (PTC), and verified the predictive role of the risk 
      staging systems in current use. METHODS: The clinicopathological characteristics 
      and risk categories were analysed according to recurrence in patients who 
      underwent hemithyroidectomy for low- and intermediate-risk conventional PTC, and 
      were followed up for at least 24 months. Five risk staging systems were used to 
      stratify risk: the 2015 American Thyroid Association (ATA) system; Age, 
      Metastases, Extent and Size (AMES) system; Metastases, Age, Complete resection, 
      Invasion and Size (MACIS) system; Grade, Age, Metastases, Extent and Size (GAMES) 
      system; and the eighth AJCC system. RESULTS: The study included 561 patients; 
      93.9 per cent of the study population (527 of 561) had a papillary thyroid 
      microcarcinoma 1 cm or smaller in size. At a mean follow-up of 83 months, 25 
      patients (4.5 per cent) had recurrence; among these patients, 23 (92%) presented 
      with a remaining thyroid lobe. Multifocality was significantly associated with 
      recurrence in univariable and multivariable analyses (adjusted hazard ratio 3.16, 
      95 per cent c.i. 1.25 to 7.98; P = 0.015). Disease-free survival (DFS) varied 
      according to multifocality (P = 0.010). The five risk staging systems were not 
      associated with recurrence, and their Harrell's C-index ranged from 0.500 to 
      0.531. DFS rates did not differ between the risk categories in each system. 
      CONCLUSION: Although the recurrence rate after hemithyroidectomy in patients with 
      low- and intermediate-risk PTC was low, meticulous follow-up focusing on the 
      remaining thyroid lobe is needed for early detection and timely management of 
      recurrence. The risk scoring systems in current use have no predictive role in 
      these patients.
CI  - (c) 2020 BJS Society Ltd Published by John Wiley & Sons Ltd.
FAU - Ahn, D
AU  - Ahn D
AUID- ORCID: 0000-0002-4977-7406
AD  - Department of Otolaryngology - Head and Neck Surgery, Kyungpook National 
      University, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, Korea.
FAU - Lee, G J
AU  - Lee GJ
AD  - Department of Otolaryngology - Head and Neck Surgery, Kyungpook National 
      University, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, Korea.
FAU - Sohn, J H
AU  - Sohn JH
AD  - Department of Otolaryngology - Head and Neck Surgery, Kyungpook National 
      University, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, Korea.
LA  - eng
PT  - Journal Article
DEP - 20200205
PL  - England
TA  - Br J Surg
JT  - The British journal of surgery
JID - 0372553
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Clinical Decision Rules
MH  - Follow-Up Studies
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - *Neoplasm Recurrence, Local/diagnosis/epidemiology/etiology/pathology
MH  - Neoplasm Staging
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Survival Analysis
MH  - Thyroid Cancer, Papillary/mortality/pathology/*surgery
MH  - Thyroid Neoplasms/mortality/pathology/*surgery
MH  - *Thyroidectomy/methods
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2020/02/07 06:00
MHDA- 2020/12/29 06:00
CRDT- 2020/02/07 06:00
PHST- 2019/07/08 00:00 [received]
PHST- 2019/10/01 00:00 [revised]
PHST- 2019/10/19 00:00 [accepted]
PHST- 2020/02/07 06:00 [pubmed]
PHST- 2020/12/29 06:00 [medline]
PHST- 2020/02/07 06:00 [entrez]
AID - 10.1002/bjs.11430 [doi]
PST - ppublish
SO  - Br J Surg. 2020 May;107(6):687-694. doi: 10.1002/bjs.11430. Epub 2020 Feb 5.