A Surgical Approach For Unilateral Multifocal Papillary Thyroid Carcinoma Of T1/2cN0M0-Feasibility Analysis Of Unilateral Lobectomy With Isthmus Resection

Objective: To compare the clinical data of patients with unilateral unifocal papillary thyroid carcinoma(T1/2CN0M0)and unilateral multifocal papillary thyroid carcinoma undergoing lateral thyroid lobe and isthmus excision with ipsilateral central lymph node dissection,and to analyze the feasibility of using this surgical procedure as the preferred surgical method for unilateral multifocal papillary thyroid carcinoma(T1/2CN0M0).Methods: Clinical data of patients with papillary thyroid carcinoma admitted to the Department of General Surgery,Shengjing Hospital Affiliated to China Medical University from January 2013 to December 2016 were collected.The operation was performed by thyroid lobotomy with isthmus resection on the affected side and lymph node dissection in the ipsilateral central region.Thyroid ultrasonography was performed every 6 months after surgery.If ultrasonography suggested contralateral nodules and nodules with TI-RADS rating of Class 4 or above,fine needle puncture cytology was recommended.All patients were followed up until January 21,2021,from the time of diagnosis of papillary thyroid carcinoma.Univariate analysis of general data was performed using the chi-square test(Fisher’s exact test)or Pearson’s chi-square test.Kaplan-Meier method was used to calculate the survival time without recurrence,and the survival curve was drawn.P < 0.05 was considered statistically significant.Results: Up to January 2021,a total of 285 follow-up cases were collected and completed.They were divided into two groups according to unilateral single lesion and unilateral multi-lesion.There were no statistically significant differences in gender,age,tumor diameter and lymph node metastasis between the two groups.By the end of follow-up,the recurrence rate of contralateral lobar carcinoma was 2.6% in the unifocal group and 5.6% in the multifocal group,and there was no significant difference between the two groups(P > 0.05).Kaplan-Meier method was used to analyze the recurrent-free survival rate of the contralateral glandular lobes in the unifocal group and the multifocal group.Although the 5-year recurrent-free survival rate of the unifocal group was slightly higher than that of the multifocal group(96.4%),the difference between the two groups was not statistically significant(P > 0.05).Conclusion: T1/2cN0M0 patients with unilateral multifocal papillary thyroid carcinoma may have a better quality of life if only the affected side thyroid lobectomy and isthmus resection with ipsilateral central lymph node dissection can be performed.o investigate whether unilateral multifocal papillary thyroid carcinoma recurrence is affected by resection of the affected thyroid lobes and isthmus accompanied by ipsilateral lymph node dissection.