Domenico Albano1,2, Giorgio Treglia3,4,5, Francesco Dondi6, Raffaele Giubbini7, Alessandro Galani8, Carlo Cappelli9, Francesco Bertagna6,7, Claudio Casella10. 1. Nuclear Medicine, ASST Spedali Civili Brescia, Brescia, Italy. domenico.albano@unibs.it. 2. Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health; Nuclear Medicine, University of Brescia, Brescia, Italy. domenico.albano@unibs.it. 3. Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland. 4. Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. 5. Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland. 6. Nuclear Medicine, ASST Spedali Civili Brescia, Brescia, Italy. 7. Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health; Nuclear Medicine, University of Brescia, Brescia, Italy. 8. Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy. 9. Department of Clinical and Experimental Sciences, SSd Medicina ad Indirizzo Endocrino-Metabolico, University of Brescia, Brescia, Italy. 10. Department of Molecular and Translation Medicine, Surgical Clinic, University of Brescia, Brescia, Italy.
Abstract
PURPOSE: Thyroid nodules classified as TIR3B according to SIAPEC 2014 are considered a clinical challenge due to the risk to be malignant. This retrospective study aimed to compare the performances of total thyroidectomy (TT) and hemithyroidectomy (HT) in the surgical management of a consecutive cohort of patients affected by TIR3B thyroid nodule in terms of side effects and the rate of malignancy detected. METHODS: From 2011 to 2019, 136 (111 women, 25 men; average age of 53.5 years) patients having a thyroid nodule with a cytological diagnosis of TIR3B who underwent TT or HT were retrospectively included. RESULTS: Out of 136 patients, 106 (78%) received TT, while the remaining 30 (22%) HT. The final diagnosis was malignant in 65 patients (48%), with follicular variant of papillary carcinoma as the most frequent. The diagnosis of malignancy was significantly more common in the TT group with 56 patients (53%) compared to the HT group with 9 cases (30%) (p = 0.001). Patients who underwent TT were significantly older, had larger nodules and the time between diagnosis and surgery was significantly longer compared to HT (p = 0.001; p0.003; p = 0.002). No main post-surgical complications were registered, except for one case of transient hypocalcemia in a patient who underwent TT. CONCLUSIONS: Our data showed a malignancy rate of TIR3B lesions higher than expected (48%). Both TT and HT seem to be effective approaches for the treatment of TIR3B nodules with a very low rate of post-surgical comorbidities. In the choice of surgical approach, it is crucial to consider the presence of risk factors (clinical and ultrasound characteristics), nodule size, patients' opinion, and surgeon's skills and experience.
PURPOSE: Thyroid nodules classified as TIR3B according to SIAPEC 2014 are considered a clinical challenge due to the risk to be malignant. This retrospective study aimed to compare the performances of total thyroidectomy (TT) and hemithyroidectomy (HT) in the surgical management of a consecutive cohort of patients affected by TIR3B thyroid nodule in terms of side effects and the rate of malignancy detected. METHODS: From 2011 to 2019, 136 (111 women, 25 men; average age of 53.5 years) patients having a thyroid nodule with a cytological diagnosis of TIR3B who underwent TT or HT were retrospectively included. RESULTS: Out of 136 patients, 106 (78%) received TT, while the remaining 30 (22%) HT. The final diagnosis was malignant in 65 patients (48%), with follicular variant of papillary carcinoma as the most frequent. The diagnosis of malignancy was significantly more common in the TT group with 56 patients (53%) compared to the HT group with 9 cases (30%) (p = 0.001). Patients who underwent TT were significantly older, had larger nodules and the time between diagnosis and surgery was significantly longer compared to HT (p = 0.001; p0.003; p = 0.002). No main post-surgical complications were registered, except for one case of transient hypocalcemia in a patient who underwent TT. CONCLUSIONS: Our data showed a malignancy rate of TIR3B lesions higher than expected (48%). Both TT and HT seem to be effective approaches for the treatment of TIR3B nodules with a very low rate of post-surgical comorbidities. In the choice of surgical approach, it is crucial to consider the presence of risk factors (clinical and ultrasound characteristics), nodule size, patients' opinion, and surgeon's skills and experience.
Authors: Benjamin A Taylor; Robert D Hart; Matthew H Rigby; Jonathan Trites; S Mark Taylor; Paul Hong Journal: J Otolaryngol Head Neck Surg Date: 2016-02-27
Authors: Carlo Cappelli; Ilenia Pirola; Elena Gandossi; Mario Rotondi; Davide Lombardi; Claudio Casella; Fiorella Marini; Maura Saullo; Barbara Agosti; Elena Di Lodovico; Luca Chiovato; Alberto Ferlin; Maurizio Castellano Journal: Int J Endocrinol Date: 2020-04-21 Impact factor: 3.257