Tiroidectomia em carcinomas papilares de risco baixo - intermédio: estudo descritivo

Abstract

Background: Current ATA guidelines recommend hemithyroidectomy for differentiated thyroid carcinoma smaller than 4 cm, as an acceptable alternative initial procedure to total thyroidectomy. With this study, we intend to study the incidence of thyroidectomies that could have been avoided, in patients with a cytological diagnosis of unilateral papillary carcinoma smaller than 4 cm. Methods: In this retrospective descriptive study, we select a cohort of patients with low to intermediate-risk unilateral papillary carcinoma smaller than 4 cm who underwent initial thyroidectomy or thyroid lobectomy in a Portuguese tertiary medical centre from January 2008 to July 2021. Data related to carcinoma cytohistological characteristics and therapeutic approaches and was collected and analysed using IBM SPSS Statistics. Results: Out of a total of 270 unilateral papillary carcinoma smaller than 4 cm, 254 (94,1%) underwent total thyroidectomy and 16 (5,9%) underwent lobectomy. Of the 254 thyroidectomies, 106 would not need this approach, as they did not perform ablative therapy with radioactive iodine. Conclusion: For these patients with low-intermediate papillary carcinoma, the extent of the initial surgical treatment should be questioned, in order to reduce the need for surgical reintervention, as well as the possibility of safely starting with a more conservative approach such as lobectomy.