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Unilateral thyroidectomy for patients of the low-risk group with differentiated thyroid carcinoma: an unsuitable surgery

BACKGROUND: Recent studies challenge the efficacy of unilateral resection in the prevention of recurrences in differentiated thyroid carcinoma of low-risk group. Our objectives were to compare recurrence rates after unilateral and bilateral resections in our so-called low-risk group and to evaluated the accuracy of the criteria used to classify patients into high and low-risk group. METHODS: We evaluate outcome of 169 patients who underwent surgery for differentiated thyroid carcinoma at the HUCFF. They were divided in 2 groups: low-risk patients (n = 127) and high-risk patients (n = 42). Unilateral resection was undertaken in 71 patients of the low-risk group and in 4 of the high-risk group; bilateral resection was the operation used in 56 and 38 patients, respectively, in each of these groups. RESULTS: Follow-up was obtained in 155 patients in a mean period of 8.4 years for 116 low-risk patients and 5 years for 39 high-risk ones. In high-risk group recurrence occurred in 3 patients (7.5%) and there were 5 tumor related deaths (12.5%). In the low-risk group, there were 13 recurrences (8,3%) but no death occurred. The difference in recurrence rate between groups does not attain statistical e significance (p= 0.57). Recurrence occurred in 5 (7.5%) in the low-risk patients submmited to unilateral resection and in 5 (10%) of those submmited to bilateral resection. CONCLUSIONS: The division of patients with differentiated thyroid carcinoma in high and low-risk groups is useful is predicting more aggressive recurrences and tumor-related deaths. Unilateral resection in low-risk patients is not associated with higher recurrence rates.

Thyroid cancer; Risk-groups; Total lobectomy


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