COMPLETION THYROIDECTOMY IN THYROID CANCER. SURGICAL FINDINGS.

AUTHORS:
D. Ceniza Pena (Santander, Spain) , C. García Rodríguez-Maimón (Santander, Spain) , J. García Cardo (Santander, Spain) , G. Gutiérrez Fernández (Santander, Spain) , E. García Somacarrera (Santander, Spain) , A. Lopez Useros (Santander, Spain) , E.J. Anderson Anderson (Santander, Spain)
Background:
Current guidelines show no consensus regarding the indication of completion thyroidectomy versus close follow-up in patients diagnosed with thyroid carcinoma after hemithyroidectomy. The descriptive study analyzes histological findings in a series of completion thyroidectomes performed at our center.
Methods:
A retrospective descriptive analysis was performed on a prospectively collected database of completion thyroidectomies undertaken in our center between 2009 and 2022. Characteristics such as histology, multifocality, size, Bethesda and TIRADS were described.
Results:
Out of 122 completion thyroidectomies, histological diagnosis of thyroid carcinoma in hemithyroidectomy was the surgical indication in 43 patients. Histological findings after the initial hemithyroidectomy were papillary carcinoma in 55.8%, follicular carcinoma in 23.3%, micropapillary carcinoma in 14% and medullary carcinoma in 7%. In those with initial papillary carcinoma, histological findings after completion thyroidectomy were micropapillary carcinoma in 20.8% and papillary carcinoma in 8.3%. In those with initial follicular carcinoma, micropapillary carcinoma was found in 10% of completion thyroidectomies. In those with initial micropapillary carcinoma, papillary and micropapillary carcinoma were found in 33.3% and 33.3% of completion thyroidectomies respectively. In those with an initial finding of medullary carcinoma, medullary carcinoma was found in 33.3% of completion thyroidectomies. Furthermore, ultrasound, cytological and histological findings such as size, extrathyroidal extension, multifocality and lymph node extension were analyzed in the described tumors.
Conclusions:
In patients diagnosed with thyroid carcinoma after hemithyroidectomy, the indication of completion thyroidectomy versus close follow-up should be individualized based on histological characteristics of the initial tumor.