Differentiated Thyroid Carcinoma: The Impact of Initial Surgical Therapy

ObjectiveThe extent of surgery for differentiated thyroid carcinoma (papillary and follicular) is still controversial, extending from simple lobectomy to extensive total thyroidectomy. The objective of this study was to assess the outcome of different types of thyroidectomy in patients with differentiated thyroid carcinoma (DTC).MethodsThe extent of primary surgical therapy for 428 patients with thyroid lesions who underwent surgery, in whom the final diagnosis were confirmed histologically, were reviewed. Those who developed recurrence after surgery were analyzed further.ResultsForty two patients had differentiated thyroid carcinoma. Regarding surgical treatment, 27 patients had lobectomy and 15 had total thyroidectomy. Out of six patients who developed recurrence, five had lobectomy as initial surgical treatment and one underwent subtotal thyroidectomy. None of the patients in total thyroidectomy group developed recurrence.ConclusionIn the absence of general agreement of the optimal primary surgical therapy for DTC, our data indicate that more extensive surgery has a better outcome and with less recurrence rate.