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  • br Baade PD Youlden DR Andersson TM Youl PH Walpole

    2021-03-10


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    Compliance with Ethics Requirements
    This article does not contain any studies with human or animal subjects
    Laura Botta
    Conflict of Interest
    The authors have declared no conflict of interest
    Laura Botta
    Contents lists available at ScienceDirect
    Surgery
    journal homepage: www.elsevier.com/locate/surg
    Endocrine
    Changes in total thyroidectomy versus thyroid lobectomy for papillary thyroid cancer during the past 15 years
    Benjamin C. James, MD, MSa,*, Lava Timsina, PhDb, Ryan Graham, BSc, Peter Angelos, MD, PhD, FACSd, David A. Haggstrom, MD, MASe,f,g
    a Section of Endocrine Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
    b Indiana University School of Medicine, Department of Surgery, Indianapolis
    c Indiana University School of Medicine, Indianapolis
    d Section of Endocrine Surgery, Department of Surgery, University of Chicago, IL
    e Indiana University School of Medicine, Department of Medicine, Division of General Internal Medicine and Geriatrics, Indianapolis
    f Center for Health Information and Communication, US Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service, Richard L. Roudebush VA Medical Center, Indianapolis, IN
    g Regenstrief Institute, Inc, Indianapolis, IN
    Article history:
    Background: The incidence of papillary thyroid cancer has increased substantially during the past 15 years, which is likely related to an increased detection of small, nonlethal cancers. Studies have shown that patients may have a similar prognosis when undergoing less aggressive surgical intervention, such as thyroid lobectomy. The objective of lungs study is to determine whether surgical treatment patterns for papillary thyroid cancer have changed during the past 15 years.
    Methods: We performed a retrospective cohort study evaluating changes in the incidence and proportion of total thyroidectomy versus thyroid lobectomy for histologically confirmed papillary thyroid cancers, using the National Cancer Institute Surveillance, Epidemiology, and End Results cancer registries be-tween 2000 and 2014.
    Results: During the study period, 44,537 patients underwent surgical treatment for papillary thyroid cancer, of which 77% were female and 81.3% were white. The incidence of papillary thyroid cancer more than doubled: from 6.2 (5.9e6.5) to 13.0 (12.5e13.4) per 100,000. The proportion of total thyroidectomy among all papillary cases increased from 78.16% in 2000 to 85.67% in 2014, and the proportion of thyroid lobectomy dropped from 16.62% to 11.41%. When stratified by tumor size, we observed a sustained and increasing gap in the proportions of total thyroidectomy and thyroid lobectomy.
    Conclusion: The incidence of total thyroidectomy has not decreased despite recommendations encour-aging consideration of lobectomy for patients with small papillary thyroid cancers. Although these findings could be attributed to the lag between scientific evidence and clinical practice, further work is warranted to explore any additional patient and provider factors that may explain this lack of change.
    Introduction
    Throughout the past several decades, the incidence of thyroid cancer has increased by 3% annually, and thyroid cancer is close to being the third most-common cancer type in women.1,2 The ma-jority of this increase has occurred in small papillary thyroid
    * Reprint requests: Benjamin C. James, MD, MS, Chief, Section of Endocrine Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Assistant Professor of Surgery, Harvard Medical School, 185 Pilgrim Road, Palmer 605, Boston, MA 02115.
    E-mail address: [email protected] (B.C. James).