Özer Makay1, Murat Özdemir1, Yasemin Giles Şenyürek1, Fatih Tunca1, Mete Düren1, Mehmet Uludağ1, Mehmet Hacıyanlı1, Gökhan Içöz1, Adnan Işgör1, Serdar Özbaş1, Zehra Özcan1, Serdar Tezelman1. 1. Departments of General Surgey (Ö.M., M.Ö. muratozdemir.md@gmail.com, G.İ.) and Nuclear Medicine (Z.Ö.), Ege University School of Medicine, İzmir, Turkey; Department of General Surgey (Y.G.Ş., F.T.), İstanbul University İstanbul School of Medicine, İstanbul, Turkey; Department of General Surgery (M.D.), İstanbul University Cerrahpaşa School of Meidicine, İstanbul, Turkey; Department of General Surgey (M.U.), Şişli Etfal Training and Research Hospital, İstanbul, Turkey; Department of General Surgery (M.H.), İzmir Katip Çelebi University, Atatürk Tranining and Research Hospital; Department of General Surgery (A.İ.), Bahçeşehir University School of Medicine, İstanbul, Turkey; Department of General Surgery (S.Ö.), Güven Hospital, Ankara, Turkey; Department of General Surgery (S.T.), Koç University School of Medicine, İstanbul, Turkey.
Abstract
OBJECTIVES: The incidence of papillary microcarcinomas, which are defined as thyroid cancers of <10mm in size, has been increasing in the last decade. Herein, we present internet-based questionnaire results performed by the Turkish Association of Endocrine Surgery with the aim to evaluate the perspective of the management of papillary microcarcinomas in Turkey. MATERIAL AND METHODS: The user-friendly questionnaire consisted of 13 questions in total. These questions mainly addressed the surgical management of nodules and cancer of <1 cm in size. Patient management before, during, and after surgical intervention was also included; additionally, the "active surveillance approach" was questioned. RESULTS: There were 420 responders in total who were of multidisciplinary origin (endocrinologists, surgeons, nuclear medicine specialists, pathologists, and oncologists). Total thyroidectomy was the predominant treatment approach (65%) for the classical type of microcarcinoma limited in one lobe, whereas in cases of microcarcinomas incidentally diagnosed during hemithyroidectomy, complementary surgery approach was advised by 40% of the responders. The responders found capsule invasion (86%) and patient based management (94%) of high importance. The percentage of the responders who recommended radioactive iodine ablation in incidental cancers having no aggressive criteria was 51%. The survey participants that were against routine central dissection in these cases accounted for 73% of the responders. The recommendation of active surveillance (follow-up without any interventional therapy) was limited with 9% responders. CONCLUSION: The results of the questionnaire demonstrated that there have been various choices in Turkey for the surgical treatment of the papillary microcarcinomas.
OBJECTIVES: The incidence of papillary microcarcinomas, which are defined as thyroid cancers of <10mm in size, has been increasing in the last decade. Herein, we present internet-based questionnaire results performed by the Turkish Association of Endocrine Surgery with the aim to evaluate the perspective of the management of papillary microcarcinomas in Turkey. MATERIAL AND METHODS: The user-friendly questionnaire consisted of 13 questions in total. These questions mainly addressed the surgical management of nodules and cancer of <1 cm in size. Patient management before, during, and after surgical intervention was also included; additionally, the "active surveillance approach" was questioned. RESULTS: There were 420 responders in total who were of multidisciplinary origin (endocrinologists, surgeons, nuclear medicine specialists, pathologists, and oncologists). Total thyroidectomy was the predominant treatment approach (65%) for the classical type of microcarcinoma limited in one lobe, whereas in cases of microcarcinomas incidentally diagnosed during hemithyroidectomy, complementary surgery approach was advised by 40% of the responders. The responders found capsule invasion (86%) and patient based management (94%) of high importance. The percentage of the responders who recommended radioactive iodine ablation in incidental cancers having no aggressive criteria was 51%. The survey participants that were against routine central dissection in these cases accounted for 73% of the responders. The recommendation of active surveillance (follow-up without any interventional therapy) was limited with 9% responders. CONCLUSION: The results of the questionnaire demonstrated that there have been various choices in Turkey for the surgical treatment of the papillary microcarcinomas.
Authors: Juan J Sancho; Thomas W Jay Lennard; Ivan Paunovic; Frédéric Triponez; Antonio Sitges-Serra Journal: Langenbecks Arch Surg Date: 2013-12-19 Impact factor: 3.445
Authors: Bryan R Haugen; Erik K Alexander; Keith C Bible; Gerard M Doherty; Susan J Mandel; Yuri E Nikiforov; Furio Pacini; Gregory W Randolph; Anna M Sawka; Martin Schlumberger; Kathryn G Schuff; Steven I Sherman; Julie Ann Sosa; David L Steward; R Michael Tuttle; Leonard Wartofsky Journal: Thyroid Date: 2016-01 Impact factor: 6.568
Authors: Brian R Untch; Frank L Palmer; Ian Ganly; Snehal G Patel; R Michael Tuttle; Jatin P Shah; Ashok A Shaha Journal: Ann Surg Oncol Date: 2013-12-24 Impact factor: 5.344