Comparison Of Different Thyroidectomy Extent Of Micro-Papillary Thyroid Carcinoma

Background: To analyze the extent of thyroidectomy and prognosis of micro-papillary thyroid cacinoma(mPTC).Methods:154cases of patients with unilateral mPTC who underwent thyroidectomy at Shandong Provincial Hospital between January2005and December2009were analyzed retrospectively. All cases were diagnosed by high-frequency ultrasound preoperatively and the diameters of all the nodules were confirmed to be10mm or less by surgical pathology. Every case of thyroidectomy was the initial surgery to the patient. All the patients accepted long-term TSH suppression therapy after thyroidectomy. The cases were divided into three groups in accordance with the extent of thyroidectomy. A for subtotal thyroidectomy, B for lobectomy plus isthmic resection, C for total thyroidectomy. Patients without lymph node metastasis were devided into Group Ao, Bo and Co repectively. The long-term outcomes of postoperative complication and disease free survival were assessed statistically. COX proportional hazards regression model was used to analysis the impact of prognosis factors. Statistical analysis:SPSS17.0was used for statistical data-processing. P<0.05for the differences were statistically significant. Results:There was only4of46cases with postoperative numbness because of low calcium in Group A.7of68in Group B and27of40in Group C. All the154cases had no laryngeal recurrent nerve injury. The incidence of parathyroid injury was obviously higher in Group C than Group A&B. The difference was statistically significant (P<0.05). This study applied COX proportional hazards regression model to analysis prognosis factors. The results showed that the relationship between gender, age, unifocal or multicentral, size and disease free survival was not closely, but whether lymph node of level VI or neck metastasis were associated with disease free survival.To balance the bias of choice, this study only compared the patients without lymph node metastasis and found that the differences of recurrence rate between the three groups of patients had no statistical significance (P>0.05).Conclusion:This study found that the rates of postoperative complications between groups were statistically different. The relationship between gender, age, unifocal or multicentral,size and disease free survival was not closely, but whether lymph node of level Ⅵ or neck metastasis were associated with disease free survival. The recurrence rate of mPTC has no obvious correlation with the extent of thyroidectomy. This may indicate that the operation extent can be reduced which is helpful to reduce the occurrence of postoperative complications.